I feel like this is anything but shocking and the wrong takeaway? The source, as I understand it, is just where the person is living. It doesn't distinguish from people who worked from home, worked because they were essential, or those who have been going out socially.
66% of the people in the hospital are people who normally live at home. What percent of the normal population lives at home - 90%?
This was my reaction as well and left me wondering if there is missing information here.
NYC has been on lockdown for weeks. A very large percentage of the city is staying home. Some completely isolated, but most are not completely isolated.
People have periodic contact with family, friends, neighbors, pharmacies, grocery stores, and/or delivery people. People who live in buildings with shared common areas (doors, entryways, elevators, mail rooms, laundry rooms, ventilation systems, etc.) cannot help but risk some exposure. Masks and social distancing are not 100% effective.
It's actually been since March 22nd so well into its second month now. When the order is lifted on the 15th it will be a week shy of two months. On it's face anyway the news definitely isn't encouraging.
There is some info that hints that the people at home are not venturing out much.
I personally find this alarming that there is still widespread community spread. In my more rural state I think there is community spread, but nursing homes and long term care facilities are still dominating hospitalizations and deaths.
If there is much socialising and lack of testing and tracing, it may be alarming due to new cases. In places without contagion, there needs to be preparedness, or risk another round. Italy/France/Spain took their time until lockdown and rest of Europe learned from that. This needs planning and leadership, then opening may be OK.
> I personally find this alarming that there is still widespread community spread.
You should probably expect it - you only end community spread in short order with R=0. With, say R=0.5, you get something like a ten day half-life for number cases. Furthermore, tests tend to have ramped up after social restrictions, so number of new cases isn't a useful figure outside of the context of % of positive tests, and deaths are a lagging indicator.
In both France and Italy seven weeks of hard lockdown have only reduced deaths to about a quarter in that time-frame.
>"There is some info that hints that the people at home are not venturing out much."
What are those hints exactly? Cell phone tower data, metro card swipes, bandwidth usage? I'm guessing it's not yet warm enough for power consumption(ACs usage) to be an indicator.
It seems like one of the primary differences between countries that have effectively stopped Covid-19 like South Korea and Taiwan, and the US is how people are quarantined.
In the countries that were effective at stopping the spread, they quarantined sick people outside of their house. Since transmission is so effective its almost a guarantee that the rest of your household will catch it if you stay home, either by touching a shared doorknob, then touching their face, or by droplets landing on surfaces, or any number of other mechanisms.
We should seriously consider paying for hotel rooms for people that test positive. The total cost would likely be far lower than letting them infect the rest of their family.
In the article he implies these are people who are not working, not commuting, and not travelling. Here are some quotes from the article:
"He said the information shows that those who are hospitalized are predominantly from the downstate area in or around New York City, are not working or traveling and are not essential employees. He also said a majority of the cases in New York City are minorities, with nearly half being African American or Hispanic."
"Cuomo said nearly 84% of the hospitalized cases were people who were not commuting to work through car services, personal cars, public transit or walking. He said a majority of those people were either retired or unemployed. Overall, some 73% of the admissions were people over age 51."
Have you seen those photos of crowded subway platforms in the early morning? Almost all minorities on their way to gig worker jobs in the city - delivery people, etc. These are the essential workers that are still delivering food and groceries to the rest of NYC that is sheltering in place.
It doesn't surprise me that the rate of infection by those staying home, that are in poor neighborhoods and minorities, is high. How many of those households have an essential worker in their family? How many of them might be living in large multi-generational families where one or more are instacart shoppers, Uber/Lyft drivers, etc?
We need more data before we can really determine if this is surprising or not.
I'll tell you what I thought immediately after seeing those photos:
- First reaction: OMG, those people are not social distancing and are putting everyone at risk.
- Second reaction: If those essential workers can't deliver food to all the people trapped in their apartments, society would collapse very quickly.
I don't trust people saying they are 'staying at home' if the data is self-reported rather than verified by a third party.
Living in Brooklyn in a predominantly hispanic neighborhood (relevant only because the article mentions it hitting black and hispanic communities hardest), had to venture out this weekend for the first time in weeks to facilitate moving apartments.
Observations:
1. An incredibly high amount of people are out and about, even people who seem to just be socializing, standing around / hangout out on their stoop, talking to friends or neighbors, having small 5-15 person gatherings or cookouts
(on their stoop), or going for walks (without pets). There is a big culture among natives of socializing outside in front of your building, gathering to share in smoking, eating, listening to music, and chatting, which is honestly a beautiful thing about New York when it isn't a pandemic. But these gatherings seemingly haven't decreased, at least not to the degree one might expect.
2. An incredible amount of people have access to surgical masks. This was news to me as I figured stocks were still depleted, but it turns out that they are to be found in a variety of pharmacies, groceries, hardware stores, bodegas etc. just at inflated prices and in small batches. I purchased a replacement pack of 6 surgical masks at my grocery store checkout counter for about a dollar each. I would estimate 80-90% of people in public here are wearing a mask, mostly surgical, a minority KN95 (also was available at the grocery I was at in individual units at a fairly high price) or bandana/improvised masks.
3. A huge percentage (maybe 30-45%)? of people that I see wearing masks seem to be putting them around their chins or wearing them over their mouth but with nostrils exposed or hanging around their neck. Or I see people pulling them down and only pulling them back up when they walk by someone or go into a store (most stores have signs on the entrance requiring masks but state that improvised is OK).
It's incredibly frustrating seeing people wearing PPE incorrectly and/or treating it as optional outside of stores.
4. The young transplant/white/yuppie minority population in the area seems to be either wearing masks correctly, clutching their grocery basket tightly with a stern look on their face or alternatively treating the whole thing like a joke and walking their dogs outside shining new development luxury buildings with a look of glee and wearing no masks at all. For the most part they are not to be seen at all except for seemingly in a grocery store or walking back from one, or walking a pet. Where I would normally see dozens of young, predominantly white hipsters in bars or at restaurants, coming and going to the subway, or just walking, now I see 10-20% of usual traffic of them.
5. Older people seem to be more likely than younger people to be wearing no mask, to be wearing a mask incorrectly, or to be just standing around on their front porch/stoop aimlessly.
Anyway, these are not meant to be construed as directly relevant as evidence for a cause for the present infection demographics as we don't have a complete picture of initial infections, of percentages of population that can work from home vs works outside as essential workers, etc.
But certainly if you asked me about what my hypothesis might be about the causes of minority populations in NYC having bad outbreaks, I would say we can't ignore self inflicted wounds due to bad education or cultural disregard / machismo around rules and authority, skepticism towards government or science, etc. No idea what the solution would be besides reducing inequality and lifting people out of poverty, improving their education, or role models within the communities stepping up and speaking out to those who flaunt social distancing.
Lastly, I don't think these communities are alone in not abiding by quarantine as much as they can, I think most of the United States is being as lackadaisica...
> Or I see people pulling them down and only pulling them back up when they walk by someone or go into a store
Where a surgical mask is 95% effective at preventing transmission; This is reasonable use.
*If only pulled up before interaction and taken off only after interaction, and treating hands that touched the mask as contaminated after taking it off, you maintain the 30% reduction in contracting the virus.
> or to be just standing around on their front porch/stoop aimlessly
If they're not within 6' of another person; there is nothing inherently bad about being outside.
> Where a surgical mask is 95% effective at preventing transmission; This is reasonable use.
I think we're still waiting on data on how much virus gets in the air from normal breathing, but it seems plausible that it's not insignificant and may be reduced drastically by you wearing a mask. If you're leaving a cloud of virus in your path, putting on a mask for only the few seconds you're passing someone isn't going to do anything about the cloud of virus you could possibly be leaving in your wake.
> If they're not within 6' of another person; there is nothing inherently bad about being outside.
6ft is a bit of an arbitrary number that's easy to remember, but people are treating it like it's some magic shield. Time spent in proximity presumably plays a factor as well. Walking quickly past someone at 3ft away is probably a lot safer than standing 10ft away from someone and talking for ten minutes. Being outside certainly should help, but in a place with a high concentration of people with the virus I would not consider it a safe activity.
I think there's some really invalid assumptions going on with the reasoning here. I don't have an exact answer, but I can challenge these assumptions.
You don't leave a "virus cloud path" behind you. It just follows the wind in random directions and quickly disperses within a few feet to concentrations that are safe (studies have shown that viral load of initial exposure is a significant factor in disease severity). Below a certain concentration, your immune system will just handle the few viral cells which landed on you.
I would challenge the 3ft vs 10ft thing as actually being a big stretch. I think further research is needed to say anything about that for sure, but keep in mind that beyond some certain distance, probably around 10 feet, distance stops mattering. In some sense, 100 ft is the same as 1000 ft. I would guess the threshold where distance stops mattering is somewhere between 6ft and 10ft, and realistically 10ft should be safe.
> Below a certain concentration, your immune system will just handle the few viral cells which landed on you.
We don't know what a "low viral load" means for infectiousness.
Yes, maybe you fight off the virus successfully after being exposed to a low amount of virus. But perhaps you are infectious for 2 days and infect 2 people.
> We don't know what a "low viral load" means for infectiousness.
One way the phrase is used refers to severity being dependent on initial viral load. That's what I think you're talking about. Someone can have a mild infection or asymptomatic but still be contagious.
I've had a similar experience traveling about the San Francisco bay area. In certain parts of the peninsula folks seem to be respecting the shelter in place and doing the whole PPE thing. Down in the South Bay there's about three different neighborhoods I passed through that definitely have a lot more action going on with people out and about, walking, biking, kids playing, groups of teens wandering around.
It's palpable the difference in behavior across demographics. I can even experience ramped up activity just going through the freeway through certain cities, some are dead, others are pretty active. Would be a great lil documentary with a dash cam sampling different neighborhoods. Population density is a function of the differences as well I'd imagine.
In Palo Alto, I see some people out and about but almost everyone is wearing a mask, sticking with family groups, and mindful of keeping a distance from other groups of people. The only exception is parks, which I avoid like the plague.
Americans clearly are failing to get hand of the situation. Daily rate of new infections has stayed almost constant for as long as for a month. Fortunately it is skyrocketing but it is not declining either.
In Hong Kong, 1 of the transmission vectors for SARS and COVID19 is from sewage pipes in high-rise apartments. Body fluid goes into the drain and its droplets spread to floor above and below the infected unit's.
And the vent pipes leaked anywhere that someone cut the vent to make room in their bathroom — which the articles say was common. In principle, it's helpful to know that sewer fumes might allow covid to spread. But based on those two articles, the fact that many toilet / drain traps in that building appear to be dry, and given the hacked up state of that building's sewer and vent stacks, neither story clarifies how covid actually spread there. Nor should the reader assume the same is likely to happen in another building that conforms to building codes — unlike that one.
That's a newspaper article that doesn't even claim that C19 did spread in that manner, merely that people are worried about it. You presented it as a fact ("1 of the transmission vectors"). If that's all you are basing this on, please stop spreading misinformation.
Faecal oral transmission is an active research topic, but it does not appear to be a major infection vector. There is no evidence to date that this has occurred.
Wow, I would have thought that a p-trap filled with water would have blocked gases from the drain waste vent system. What's going on here, do the vents not vent all the way to the top of the building but come out the sides of the buildings? Guess they'd have to at some point as the number of stories goes on and on.
As expected HN comments dismiss this evidence because it does not match the narrative. Study is dismissed as flawed, and personal anecdotes handwave the data away.
From the data it’s not clear that shelter in place orders have had anything other than a marginal effect.
The posted article is hardly "data" (at most, one poorly defined data point) and most of the questions here are pointing to how little information the article offers from which to draw conclusions-- for instance, what does "sheltering in place" mean? Where were these people? When were they leaving their houses? etc.
What data are you referring to that suggest shelter in place orders could be having only a marginal effect?
I do some contracting work for a British company, and had some extremely unrealistic deadlines looming in late February.
For this reason, I was keenly watching their government's announcements at the time and was amazed as weeks went by and my country's restrictions got tighter and tighter while the UK didn't budge.
Now, in May, it's not exactly apples to apples but they're now the hardest hit (deaths-wise) in Europe, and my country has dropped down below 1000 active cases (and decreasing some 50/day).
You could probably substitute my country for almost any other early mover and the UK for almost any other late mover and arrive at the same result. Even across different pandemics.
"Moving", here, means locking down.
Given that, my personal biases lead me to think that lockdowns probably work. I have to acknowledge that there's a moderately high bar set for data which disproves this thesis, because it's just so damned intuitive.
How does your intuition square with a country like Sweden's response to the virus who would be classified as not just a "late mover" but a "non-mover?"
As someone who thoroughly enjoyed Swedish snus for a year or two, I'd love to say that it's the nicotine interfering by binding to the AChR receptors.
In reality though, I feel like in comparatively sparsely populated places like Sweden, New Zealand, etc. there's not a lot of difference at this point between a supermarket with significant social distancing imposed and a cafe with significant social distancing restrictions imposed.
It's once you get to the densities of London, NY, Madrid, Rio and Paris that the difference starts to become important.
From the perspective of reducing the spread, this should mean that many of the US states should have been able to emulate Sweden's approach (inform citizens and trust them to cooperate - up to the reader to decide if this translates between Scandinavia and the US), and many are trying to. I guess we'll see, but I think it's pretty clear that if you're New York you don't have that option on the table.
But it's also about the relative danger. Hospitality staff in South Australia right now, were that state to return to "business as usual", probably aren't being asked to risk their lives. That is and has been a different story in different states and cities around the world.
It is like comparing a potato to a mango. First the fact that there are no official restrictions does not mean that the country is not effectively in lockdown by now. Second the death rate is about 10x compared to the countries where the lockdown was applied early.
It was fairly evident that every country will end up in a lockdown except that the countries where it was applied early did not encounter huge loss of life.
Ha Ha Ha. Your comment is just as biased in the opposite direction. There's not enough data in this article to show anything except the data itself. You certainly can't say anything about the shelter in place orders from this but there you go saying it anyway.
We're living in a hyper-partizan country right now and everything published about this virus is going to be taken by both parties as a way to support their case and attack the other. Until there's another civil war or the country decides to break into smaller nations this is only going to get worse.
This statistic is very hard to interpret without additional context. If 99% of people stay at home, the of course most people who get infected would have stayed at home. Older people, who are more likely to need hospitalization, are also more likely to stay at home. People who continue to commute to work are likely being more careful, and may also be benefitting from fewer others commuting, which reduces the risks of going outside.
The relevant metric is how many fewer people have caught it due to the lockdown, and assuming the numbers are accurate, it's pretty clear that the lockdown has substantially reduced the infection rate.
And it could be very misguiding for most people, combining with the title.
It also could be those easy targets get infected first, then people indoor. Either way, the metric seems to be not very helpful and extremely misguiding.
> “Much of this comes down to what you do to protect yourself. Everything is closed down, government has done everything it could, society has done everything it could. Now it’s up to you,” Cuomo said.
"Personal responsibility" is a great cover for not taking the pandemic seriously in February.
“I was afraid that it was going to infect my family no matter what I did. We’re past that,” Cuomo said at a press conference on April 13. “If you isolate, if you take the precautions, your family won’t get infected."
Yet also:
"Most new Covid-19 hospitalizations in New York state are from people who were staying home and not venturing much outside, a “shocking” finding, Gov. Andrew Cuomo said Wednesday."
primarily to reduce the likelihood of infectious people infecting other people.
This is not complicated.
Every Single Avoided Infection Reduces The Pandemic.
Whataboutism is irrelevant.
The virus simply does not care about logic.
It only cares about math.
If I'm infectious and wear a mask and avoid infecting you, then you and everyone you would have infected do not get the disease (from me).
If I'm part of 5% of people who are actively trying to avoid spreading the infection, then it probably does not matter much and the virus spreads and spreads and spreads.
If I'm part of 90% of people who are actively trying to avoid spreading the infection, then it matters a great deal and the virus vanishes.
Are you implying the nations who have reduced infections to manageable levels have made their entire countries biosafety level 4?
How long do you think herd immunity will last because its up for debate. What should we tell the families of the 0.08 - 0.8% of the world population who died when it turns out to not be long? Even if herd immunity lasts forever, if we get a vaccine months later many died for no reason.
So ideally we'd all line up to get voluntarily exposed, 40% (the symptomatic) of the population, across all walks of life and professions, are bedridden for one or two weeks, and society just takes the 0.5-5% hit in population (no clinical care)? I guess some people really think that's better than the alternative.
A lot of evidence shows that the more severe cases are linked to having Vitamin D deficiency. Perhaps increased COVID severity is a unexpected consequence of the the public policy of "stay home indefinitely".
This seems like exactly the experience in Wuhan and is why they started removing people that tested positive from their homes and putting them in isolation centers, so they wouldn't spread the virus to their families. The US is not doing that, so if one person gets the virus in a family almost all of them get it. It means that stopping the spread will be slower and take longer. Certainly the numbers from testing seem to be coming down very slowly anywhere in the US that has had a major outbreak. If US citizens won't stand for being isolated that way, maybe they'd be more amenable to staying in a hotel for free? The rooms are already empty anyway and I would think people would want to protect their families. The whole family could even move into adjacent rooms so they could at least be close to each other. Seems like many people would not have the space or ability to isolate a family member at home (doctors with training in this are having trouble keeping themselves from becoming infected), and without testing they might not know to do it anyway. It seems less likely the virus is spreading through the septic systems of buildings in enough buildings to make a big difference.
> maybe they'd be more amenable to staying in a hotel for free?
I would avoid American hotels first for corona risk and then for legionaires. Most will get it right, but a few large ones getting it wrong are worse than a lot of people sitting in rooms in single family houses without forced air systems.
The problem is that in order to be effective, everyone must be wearing a mask, and wearing it properly at all times.
This includes when they are talking on their cell phones. You’ve seen people pull their mask down, while talking on their phones. Well, these people may be spreading the virus around when they do that.
And yet not all health care workers are infected by SARS-CoV-2 while there are enough stories where a single person has infected large group of partying people without PPE.
Besides, it is not important to protect everyone. It is just enough to reduce R0 below 1.
You fail to understand that we do not have to make it 100% secure for everyone (also it fails for healthcare workers time to time) but it would be enough if we can make R0 to become below 1.
If a person only puts a mask on while being inside and otherwise wears it under the chin then well, bud luck, not much change to avoid infection but when infected, this person will spread it less likely to somebody else who is handling the mask properly.
Rather than arguing why we "fail to understand", you should consider reading some/all of the links I provided to find out why the research supports our position.
"On this occasion, we believe public-facing communications regarding the scientific view on the balance of risks and benefits of widespread uptake of face masks have exceeded the scientific evidence base. Efforts to communicate a position so strongly in favour of widespread use of masks in the community, against current WHO advice and in the face of persistent evidence gaps and debates, risk promoting
policy that is based more on eminence—the track record, credentials and status of the authors—than on evidence."
The Chinese were able to halt the spread of the virus through combinations of social distancing, physical isolation, lockdowns, and wearing masks in public, whether N95 or KN95.
Gloves also help limit the spread, but you have to be aware of not cross-contaminating everything. As well as hand sanitizers.
Obviously, wearing the masks alone will not do the job. You need a full spectrum of behavioral changes, in order to halt the spread of the virus. Especially the combination of social distancing, plus masks. And everyone must get educated about it. No excuses!
But at this point, you have to question if all this is worth it, as states are opening up prematurely because people want to go to the beaches.
Hell, I want to go to the beach too! But the virus containment fight is not over.
If wearing masks is so ineffective then how is it possible to explain the fact that health care workers who are wearing PPE are less likely to get the infection compared to the normal people without PPE?
Health care workers are (hopefully) wearing at least professionally made surgical masks, if not proper N95 respirators, and actually know how to use them.
(I think wearing masks makes sense as long as there's a chance they'll help—but I don't think there's evidence that they necessarily do help either.)
I do not think that masks alone will be effective but in combination with other measures they will have an effect.
Ok, say most people fail to use masks to protect themselves (they take masks under their skin for example) but how does it affect protecting other people? Considering that many cases are first asymptomatic then wearing masks may considerably limit the spread.
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[ 3.6 ms ] story [ 163 ms ] thread66% of the people in the hospital are people who normally live at home. What percent of the normal population lives at home - 90%?
NYC has been on lockdown for weeks. A very large percentage of the city is staying home. Some completely isolated, but most are not completely isolated.
People have periodic contact with family, friends, neighbors, pharmacies, grocery stores, and/or delivery people. People who live in buildings with shared common areas (doors, entryways, elevators, mail rooms, laundry rooms, ventilation systems, etc.) cannot help but risk some exposure. Masks and social distancing are not 100% effective.
It's actually been since March 22nd so well into its second month now. When the order is lifted on the 15th it will be a week shy of two months. On it's face anyway the news definitely isn't encouraging.
yes https://www.youtube.com/watch?v=4QJmExSMz28
I personally find this alarming that there is still widespread community spread. In my more rural state I think there is community spread, but nursing homes and long term care facilities are still dominating hospitalizations and deaths.
You should probably expect it - you only end community spread in short order with R=0. With, say R=0.5, you get something like a ten day half-life for number cases. Furthermore, tests tend to have ramped up after social restrictions, so number of new cases isn't a useful figure outside of the context of % of positive tests, and deaths are a lagging indicator.
In both France and Italy seven weeks of hard lockdown have only reduced deaths to about a quarter in that time-frame.
What are those hints exactly? Cell phone tower data, metro card swipes, bandwidth usage? I'm guessing it's not yet warm enough for power consumption(ACs usage) to be an indicator.
In the countries that were effective at stopping the spread, they quarantined sick people outside of their house. Since transmission is so effective its almost a guarantee that the rest of your household will catch it if you stay home, either by touching a shared doorknob, then touching their face, or by droplets landing on surfaces, or any number of other mechanisms.
We should seriously consider paying for hotel rooms for people that test positive. The total cost would likely be far lower than letting them infect the rest of their family.
"He said the information shows that those who are hospitalized are predominantly from the downstate area in or around New York City, are not working or traveling and are not essential employees. He also said a majority of the cases in New York City are minorities, with nearly half being African American or Hispanic."
"Cuomo said nearly 84% of the hospitalized cases were people who were not commuting to work through car services, personal cars, public transit or walking. He said a majority of those people were either retired or unemployed. Overall, some 73% of the admissions were people over age 51."
It doesn't surprise me that the rate of infection by those staying home, that are in poor neighborhoods and minorities, is high. How many of those households have an essential worker in their family? How many of them might be living in large multi-generational families where one or more are instacart shoppers, Uber/Lyft drivers, etc?
We need more data before we can really determine if this is surprising or not.
I'll tell you what I thought immediately after seeing those photos: - First reaction: OMG, those people are not social distancing and are putting everyone at risk. - Second reaction: If those essential workers can't deliver food to all the people trapped in their apartments, society would collapse very quickly.
Living in Brooklyn in a predominantly hispanic neighborhood (relevant only because the article mentions it hitting black and hispanic communities hardest), had to venture out this weekend for the first time in weeks to facilitate moving apartments.
Observations:
1. An incredibly high amount of people are out and about, even people who seem to just be socializing, standing around / hangout out on their stoop, talking to friends or neighbors, having small 5-15 person gatherings or cookouts (on their stoop), or going for walks (without pets). There is a big culture among natives of socializing outside in front of your building, gathering to share in smoking, eating, listening to music, and chatting, which is honestly a beautiful thing about New York when it isn't a pandemic. But these gatherings seemingly haven't decreased, at least not to the degree one might expect.
2. An incredible amount of people have access to surgical masks. This was news to me as I figured stocks were still depleted, but it turns out that they are to be found in a variety of pharmacies, groceries, hardware stores, bodegas etc. just at inflated prices and in small batches. I purchased a replacement pack of 6 surgical masks at my grocery store checkout counter for about a dollar each. I would estimate 80-90% of people in public here are wearing a mask, mostly surgical, a minority KN95 (also was available at the grocery I was at in individual units at a fairly high price) or bandana/improvised masks.
3. A huge percentage (maybe 30-45%)? of people that I see wearing masks seem to be putting them around their chins or wearing them over their mouth but with nostrils exposed or hanging around their neck. Or I see people pulling them down and only pulling them back up when they walk by someone or go into a store (most stores have signs on the entrance requiring masks but state that improvised is OK).
It's incredibly frustrating seeing people wearing PPE incorrectly and/or treating it as optional outside of stores.
4. The young transplant/white/yuppie minority population in the area seems to be either wearing masks correctly, clutching their grocery basket tightly with a stern look on their face or alternatively treating the whole thing like a joke and walking their dogs outside shining new development luxury buildings with a look of glee and wearing no masks at all. For the most part they are not to be seen at all except for seemingly in a grocery store or walking back from one, or walking a pet. Where I would normally see dozens of young, predominantly white hipsters in bars or at restaurants, coming and going to the subway, or just walking, now I see 10-20% of usual traffic of them.
5. Older people seem to be more likely than younger people to be wearing no mask, to be wearing a mask incorrectly, or to be just standing around on their front porch/stoop aimlessly.
Anyway, these are not meant to be construed as directly relevant as evidence for a cause for the present infection demographics as we don't have a complete picture of initial infections, of percentages of population that can work from home vs works outside as essential workers, etc.
But certainly if you asked me about what my hypothesis might be about the causes of minority populations in NYC having bad outbreaks, I would say we can't ignore self inflicted wounds due to bad education or cultural disregard / machismo around rules and authority, skepticism towards government or science, etc. No idea what the solution would be besides reducing inequality and lifting people out of poverty, improving their education, or role models within the communities stepping up and speaking out to those who flaunt social distancing.
Lastly, I don't think these communities are alone in not abiding by quarantine as much as they can, I think most of the United States is being as lackadaisica...
Where a surgical mask is 95% effective at preventing transmission; This is reasonable use.
*If only pulled up before interaction and taken off only after interaction, and treating hands that touched the mask as contaminated after taking it off, you maintain the 30% reduction in contracting the virus.
> or to be just standing around on their front porch/stoop aimlessly
If they're not within 6' of another person; there is nothing inherently bad about being outside.
I think we're still waiting on data on how much virus gets in the air from normal breathing, but it seems plausible that it's not insignificant and may be reduced drastically by you wearing a mask. If you're leaving a cloud of virus in your path, putting on a mask for only the few seconds you're passing someone isn't going to do anything about the cloud of virus you could possibly be leaving in your wake.
> If they're not within 6' of another person; there is nothing inherently bad about being outside.
6ft is a bit of an arbitrary number that's easy to remember, but people are treating it like it's some magic shield. Time spent in proximity presumably plays a factor as well. Walking quickly past someone at 3ft away is probably a lot safer than standing 10ft away from someone and talking for ten minutes. Being outside certainly should help, but in a place with a high concentration of people with the virus I would not consider it a safe activity.
You don't leave a "virus cloud path" behind you. It just follows the wind in random directions and quickly disperses within a few feet to concentrations that are safe (studies have shown that viral load of initial exposure is a significant factor in disease severity). Below a certain concentration, your immune system will just handle the few viral cells which landed on you.
I would challenge the 3ft vs 10ft thing as actually being a big stretch. I think further research is needed to say anything about that for sure, but keep in mind that beyond some certain distance, probably around 10 feet, distance stops mattering. In some sense, 100 ft is the same as 1000 ft. I would guess the threshold where distance stops mattering is somewhere between 6ft and 10ft, and realistically 10ft should be safe.
We don't know what a "low viral load" means for infectiousness.
Yes, maybe you fight off the virus successfully after being exposed to a low amount of virus. But perhaps you are infectious for 2 days and infect 2 people.
Who each infect 2 people.
Who each infect 2 people.
Who each infect 2 people.
I shouldn't have to explain this here...
2 4 8 16 32 64 128 256 512 1024 2048 4096 8192 16,384 32,768 65,536 131,072 262,144 524,288 1,048,576
One way the phrase is used refers to severity being dependent on initial viral load. That's what I think you're talking about. Someone can have a mild infection or asymptomatic but still be contagious.
What jsharf is referring to is that below the infectious dose, exposure to the virus doesn't necessarily develop into an infection. This idea is explored here: https://erinbromage.wixsite.com/covid19/post/the-risks-know-...
It's palpable the difference in behavior across demographics. I can even experience ramped up activity just going through the freeway through certain cities, some are dead, others are pretty active. Would be a great lil documentary with a dash cam sampling different neighborhoods. Population density is a function of the differences as well I'd imagine.
In Palo Alto, I see some people out and about but almost everyone is wearing a mask, sticking with family groups, and mindful of keeping a distance from other groups of people. The only exception is parks, which I avoid like the plague.
[Edit] It was a mix / not sure -https://www.washingtonpost.com/archive/politics/2003/04/18/i...
https://www.washingtonpost.com/archive/politics/2003/04/18/i...
COVID19
https://www.scmp.com/news/hong-kong/society/article/3051209/...
Faecal oral transmission is an active research topic, but it does not appear to be a major infection vector. There is no evidence to date that this has occurred.
https://www.who.int/news-room/commentaries/detail/modes-of-t...
https://www.cdc.gov/coronavirus/2019-ncov/php/water.html
https://theconversation.com/we-dont-know-for-sure-if-coronav...
From the data it’s not clear that shelter in place orders have had anything other than a marginal effect.
What data are you referring to that suggest shelter in place orders could be having only a marginal effect?
I do some contracting work for a British company, and had some extremely unrealistic deadlines looming in late February.
For this reason, I was keenly watching their government's announcements at the time and was amazed as weeks went by and my country's restrictions got tighter and tighter while the UK didn't budge.
Now, in May, it's not exactly apples to apples but they're now the hardest hit (deaths-wise) in Europe, and my country has dropped down below 1000 active cases (and decreasing some 50/day).
You could probably substitute my country for almost any other early mover and the UK for almost any other late mover and arrive at the same result. Even across different pandemics.
"Moving", here, means locking down.
Given that, my personal biases lead me to think that lockdowns probably work. I have to acknowledge that there's a moderately high bar set for data which disproves this thesis, because it's just so damned intuitive.
This doesn't meet that bar.
In reality though, I feel like in comparatively sparsely populated places like Sweden, New Zealand, etc. there's not a lot of difference at this point between a supermarket with significant social distancing imposed and a cafe with significant social distancing restrictions imposed.
It's once you get to the densities of London, NY, Madrid, Rio and Paris that the difference starts to become important.
From the perspective of reducing the spread, this should mean that many of the US states should have been able to emulate Sweden's approach (inform citizens and trust them to cooperate - up to the reader to decide if this translates between Scandinavia and the US), and many are trying to. I guess we'll see, but I think it's pretty clear that if you're New York you don't have that option on the table.
But it's also about the relative danger. Hospitality staff in South Australia right now, were that state to return to "business as usual", probably aren't being asked to risk their lives. That is and has been a different story in different states and cities around the world.
It was fairly evident that every country will end up in a lockdown except that the countries where it was applied early did not encounter huge loss of life.
We're living in a hyper-partizan country right now and everything published about this virus is going to be taken by both parties as a way to support their case and attack the other. Until there's another civil war or the country decides to break into smaller nations this is only going to get worse.
The relevant metric is how many fewer people have caught it due to the lockdown, and assuming the numbers are accurate, it's pretty clear that the lockdown has substantially reduced the infection rate.
It also could be those easy targets get infected first, then people indoor. Either way, the metric seems to be not very helpful and extremely misguiding.
"Personal responsibility" is a great cover for not taking the pandemic seriously in February.
Yet also:
"Most new Covid-19 hospitalizations in New York state are from people who were staying home and not venturing much outside, a “shocking” finding, Gov. Andrew Cuomo said Wednesday."
Seem contradictory, no?
This is not complicated.
Every Single Avoided Infection Reduces The Pandemic.
Whataboutism is irrelevant.
The virus simply does not care about logic.
It only cares about math.
If I'm infectious and wear a mask and avoid infecting you, then you and everyone you would have infected do not get the disease (from me).
If I'm part of 5% of people who are actively trying to avoid spreading the infection, then it probably does not matter much and the virus spreads and spreads and spreads.
If I'm part of 90% of people who are actively trying to avoid spreading the infection, then it matters a great deal and the virus vanishes.
That is why we are doing this.
No, you're trying to apply logic with incorrect data.
Corona is so contagious that nothing short of a Level 4 biohazard facility can stop it, if that.
> That is why we are doing this.
No, it's just feel-good corona theater. We need herd immunity sooner than later. Let's get to 80% ASAP!
How long do you think herd immunity will last because its up for debate. What should we tell the families of the 0.08 - 0.8% of the world population who died when it turns out to not be long? Even if herd immunity lasts forever, if we get a vaccine months later many died for no reason.
We do not have to avoid 100% new infections. Just enough that R0 goes below 1.
It is dangerous to equate "acts as I do about X" with "cares about X".
I would avoid American hotels first for corona risk and then for legionaires. Most will get it right, but a few large ones getting it wrong are worse than a lot of people sitting in rooms in single family houses without forced air systems.
It’s to protect other people from you.
The problem is that in order to be effective, everyone must be wearing a mask, and wearing it properly at all times.
This includes when they are talking on their cell phones. You’ve seen people pull their mask down, while talking on their phones. Well, these people may be spreading the virus around when they do that.
The problem is that masks are not effective, and the sources I cited demonstrate this.
Besides, it is not important to protect everyone. It is just enough to reduce R0 below 1.
1) They're trained in correct PPE use
2) They wear a full set of PPE
3) They're supervised when putting it on and taking it off to avoid contaminating themselves
4) They have dedicated areas to don and doff PPE.
5) They use huge amounts of PPE. (A team will use about 30 sets of PPE per ICU patient per day.)
6) They have access to alcohol hand gel (often carrying it on them)
7) They have plentiful and easy access to handwashing facilities - elbow operated faucets, soap, running water.
8) They've been trained in handwashing, and they are regularly audited in handwashing.
If a person only puts a mask on while being inside and otherwise wears it under the chin then well, bud luck, not much change to avoid infection but when infected, this person will spread it less likely to somebody else who is handling the mask properly.
Btw. did you realize that the second link you provide supports the opposite conclusion?
"On this occasion, we believe public-facing communications regarding the scientific view on the balance of risks and benefits of widespread uptake of face masks have exceeded the scientific evidence base. Efforts to communicate a position so strongly in favour of widespread use of masks in the community, against current WHO advice and in the face of persistent evidence gaps and debates, risk promoting policy that is based more on eminence—the track record, credentials and status of the authors—than on evidence."
I am not claiming that masks are the only solution. Quite to opposite. The solution is a combination of multiple measures.
The most effective has been early social distancing so far.
The Chinese were able to halt the spread of the virus through combinations of social distancing, physical isolation, lockdowns, and wearing masks in public, whether N95 or KN95.
Gloves also help limit the spread, but you have to be aware of not cross-contaminating everything. As well as hand sanitizers.
Obviously, wearing the masks alone will not do the job. You need a full spectrum of behavioral changes, in order to halt the spread of the virus. Especially the combination of social distancing, plus masks. And everyone must get educated about it. No excuses!
But at this point, you have to question if all this is worth it, as states are opening up prematurely because people want to go to the beaches.
Hell, I want to go to the beach too! But the virus containment fight is not over.
The 2nd wave is coming, and it’s going to be bad!
(I think wearing masks makes sense as long as there's a chance they'll help—but I don't think there's evidence that they necessarily do help either.)
Ok, say most people fail to use masks to protect themselves (they take masks under their skin for example) but how does it affect protecting other people? Considering that many cases are first asymptomatic then wearing masks may considerably limit the spread.