What's the end game here? - Printable Version
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What's the end game here? - thatboy - 03-28-2020
Sorry if this has been addressed. I haven't read every thread.
I don't see the end game here. Even if we stay indoors for a couple months, as long as there are a small number of people infected won't infections start ramping up again as soon as people return to business as usual? I know the idea is to flatten the curve, but that seems more like a way to help hospitals from becoming overwhelmed rather than prevent everyone from eventually becoming infected if we eventually return to normal. I guess it's to buy more time to find treatments and/or a vaccine, as well. If nothing effective is found any time soon, though, aren't we basically screwed or am I missing something and being overly pessimistic?
It seems to me the only real endgame, barring some great treatment, is that we'll have to return to something that resembles business as usual, but includes continued working from home, where possible, wearing of masks & gloves, and some social distancing.... And just accept some continuous level of infections indefinitely.
Am I missing something?
RE: What's the end game here? - magnus - 03-28-2020
Treatment, vaccine, herd immunity or miracle.
And/or lots of deaths from an overwhelmed healthcare system and crashed economy. =/
Unfortunately, we're probably just at the beginning of the graph. First quarter if optimistic.
RE: What's the end game here? - JustAnotherFan - 03-28-2020
(03-28-2020, 01:37 PM)thatboy Wrote: Sorry if this has been addressed. I haven't read every thread.
I don't see the end game here. Even if we stay indoors for a couple months, as long as there are a small number of people infected won't infections start ramping up again as soon as people return to business as usual? I know the idea is to flatten the curve, but that seems more like a way to help hospitals from becoming overwhelmed rather than prevent everyone from eventually becoming infected if we eventually return to normal. I guess it's to buy more time to find treatments and/or a vaccine, as well. If nothing effective is found any time soon, though, aren't we basically screwed or am I missing something and being overly pessimistic?
It seems to me the only real endgame, barring some great treatment, is that we'll have to return to something that resembles business as usual, but includes continued working from home, where possible, wearing of masks & gloves, and some social distancing.... And just accept some continuous level of infections indefinitely.
Am I missing something?
I think that this article is fabulous and answers your question quite well. It's not a quick read but it is an important one and I wish everyone would read it. It's over a week old, which seems like an eternity with all the news we've been getting, but I think it is spot on. We hope to dance.
"I call the months-long period between the Hammer and a vaccine or effective treatment the Dance because it won’t be a period during which measures are always the same harsh ones. Some regions will see outbreaks again, others won’t for long periods of time. Depending on how cases evolve, we will need to tighten up social distancing measures or we will be able to release them. That is the dance of R: a dance of measures between getting our lives back on track and spreading the disease, one of economy vs. healthcare."
https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be9337092b56
RE: What's the end game here? - 2006alum - 03-28-2020
thatboy, I'm right there with you. The only nations that seem to have maintained quasi-normalcy --South Korea, Hong Kong, Taiwan, Singapore --are ones with widespread testing, a massive, nation-wide contact tracing system, effective quarantines and isolation, and a population that is very compliant about social distancing, wearing masks, etc. And even they have closed schools and massively reduced transit in and out of their territories.
I don't see a way to achieve herd immunity without utterly destroying our healthcare system and our economy. I think we'd need roughly 150m people infected in order to start developing herd immunity. But if 10-15% of those infected need to be admitted to the hospital, and approx. 5% need to be admitted to the ICU, our hospital system would be completely overrun.
Antibody testing will be a good halfway measure, because anyone with the antibodies can be much more secure in resuming normalcy, assuming the antibodies remain in sufficient number until a vaccine is available.
Some plasma treatments are also showing promise, although most have been begun when patients are already in critical condition, so that wouldn't eliminate the toll on our hospital system, just spare more lives.
Ultimately, I think it'll take a vaccine to get things fully back to normal. But even then, it will take months for a sufficient number of Americans (and others around the world) to get vaccinated.
Until then, who wants to go back to heaving and sweating next to 50 strangers at Soul Cycle, sitting in an amusement park ride that 200 strangers have touched in the hour or two before you, or standing in a packed bar?
My gut tells me this is going to alter our daily life well into 2021. I sure hope I'm wrong.
RE: What's the end game here? - UltimateCard - 03-28-2020
This article in the Atlantic lays out four scenarios with timelines ranging from a couple of months (highly unlikely) to two years:
https://www.theatlantic.com/family/archive/2020/03/coronavirus-social-distancing-over-back-to-normal/608752/
RE: What's the end game here? - M T - 03-28-2020
My view is that we've done the immediate step of shelter-in-place to reduce the deaths. Maybe it was later than best, but that is done.
We're going to still go through heart-breaking weeks of sick people dying.
It may take another month or so for new cases to get to a small number, say 1 or 2 a day for the 2M people of Santa Clara County.
Then we need to Test, Isolate, Track, Test, while we are still sheltered in place. Once that works for as many weeks until the economists turn blue in the face, then maybe we start letting some sectors go back to business. Person-to-person services (barbers, etc) might be delayed further but more essential ones (dentists) might be earlier.
Hopefully everyone knows the seriousness & the symptoms and will step up to testing if they even think they are sick.
Hopefully the tests will be plentiful and fast.
Then we need people to report ALL their contacts, not just isolated ones.
How can you possibly know who was at the grocery store with you? The Singapore app would seem to be acceptable in terms of privacy to me (or, at least, I could design a procedure that was acceptable privacy based on what I've read about it). Put a version of it on all our phones, and it could give information that would alert the others that were near me (without either of us, nor any third party, knowing the identity of the other).
So, suppose everyone in the county was free of the virus & no one was bringing it in. I reach into my freezer & take out a box of frozen beans that had been coughed on by someone that was sick 3 months earlier. As a result, I get infected and really never understand how & when it happened. i do my usual stuff and 5 or so days later I get a fever, and maybe a couple of days later a cough. Day 7 after infection, I get tested and am positive. I've been infectious since day 2 (but I don't know when that was) so I've been infectious for a week. The first of those have become infections too and have spread it.
If I don't have an exposure tracking app, I'll have to manually try to identify everywhere they've been. They may need to cough up their GPS info from their phone and/or car. Slow & labor intensive
If I do have an exposure tracking app, my phone has information about every other likewise-equipped phone it has been near for the last 2 weeks. Those people's phones poll the list of anonymous IDs of exposed phones & recognize their own anonymous ID. They then notify their owner that they may have been exposed and to get to a health clinic quickly for testing. (At this point, I think the app should identify itself to the health department, but that's a privacy issue that would be debatable.) They isolate themselves & get tested. Rinse, repeat.
If I do have an exposure tracking app on my phone, how would that help detect others around me that don't?
I don't know that bluetooth devices can detect unpaired bluetooth devices nearby. Suppose they can. If so, instead of collecting anonymized ID, it could collect the bluetooth MAC address of the device. This would be less anonymous but still allow for tracking. (Indeed, you could even have a "Warning: nearby device was possibly exposed to COVID-19" if you detect a device that has been identified as possibly exposed but has not checked.) Yes, that may be a violation of HIPAA, but maybe not (is the suspicion of exposure HIPAA protected? is the fact of being checked HIPAA protected? If so, Congress may want to amend the regulations to exclude information that is necessary for public health protection.)
IF this all works, we can catch infections (after the primary one) very early, and experience the exponential growth only when the base is 1.
Vaccines & herd immunity will come later.
RE: What's the end game here? - JustAnotherFan - 03-28-2020
(03-28-2020, 02:20 PM)2006alum Wrote: Ultimately, I think it'll take a vaccine to get things fully back to normal. But even then, it will take months for a sufficient number of Americans (and others around the world) to get vaccinated.
I wonder how bad the anti-vax community (of which plenty of people in our local communities are a part of) is going to complicate our ability to move forward. Will they recognize this as an exception that they need to participate in, or will they dismiss it kinda like they dismiss MMR or even polio vaccines?
RE: What's the end game here? - 2006alum - 03-28-2020
(03-28-2020, 03:00 PM)JustAnotherFan Wrote:(03-28-2020, 02:20 PM)2006alum Wrote: Ultimately, I think it'll take a vaccine to get things fully back to normal. But even then, it will take months for a sufficient number of Americans (and others around the world) to get vaccinated.
I wonder how bad the anti-vax community (of which plenty of people in our local communities are a part of) is going to complicate our ability to move forward. Will they recognize this as an exception that they need to participate in, or will they dismiss it kinda like they dismiss MMR or even polio vaccines?
Not sure, but if the virus wreaks such havoc on our society that only a vaccine can fully allow a return to normal, you can be sure no court in the country is going to sustain an injunction to authorities refusing to allow the unvaccinated onto airplanes, into schools, etc. As it is, the tide had already been turning on MMR antivaxers seeking exceptions.
RE: What's the end game here? - Snorlax94 - 03-28-2020
Articles like the Medium one say "all" we have to do is:
"With a few more weeks, we could get our testing situation in order, and start testing everybody"
and
"We could also set up a tracing operation like the ones they have in China or other East Asia countries"
People who think "The Dance" is going to work -- Has anyone seen any signs of any of these things in the US?
In a MercuryNews interview with Sara Cody, she said of Wuhan-style contact tracing:
“We can’t use that same strategy” due to short staffing, said Cody. “Trying to map and figure out where are some hotspots for transmission — we really don’t have the data to enable us to do that. That’s still a pretty fuzzy part of the picture.”
"All" America has to do is:
1) Be able to test everyone who needs to be tested.
2) Be able to do all the epidemiological/quarantining/contact tracing work that needs to be done. Have you seen any signs of hiring?
3) Cancel all mass events for a year (like Mardi Gras, sheesh...)
4) Make available 300 million N95 masks EACH DAY. That's what they do in Taiwan and Korea -- they have so much PPE, it's widespread among everyday people. Right now, we don't even have enough PPE for healthcare workers.
5) Be politically willing to force a national shutdown whenever needed (otherwise, people will just move around and spread the disease)
6) Shut down all international travel. For needed travel, as people get off a plane, they should be sent to designated quarantine airport hotels, where they must stay at until cleared via time and testing.
So maybe this can happen. I *wish* Trump could become the president to do these things. So far, his pattern is to do nothing and blame others, then, belatedly, after being criticized on the news for a few months, he starts to act. Based on the past pattern, everything is started about 3+ months too late. So Trump will think of 300M masks a day around December. Trump will think of hiring a national team for contact tracing around November, and then rate himself a '10'. Trump will restrict all international travel in a messy form (with brobdingnagian lines of people in customs) around August, then he will fix the brobdingnagian lines in customs problem after watching a critical segment on Fox News, so maybe there will be better airport spacing in August or September, after seeding a second massive wave across the US.
Assuming the lack of a comprehensive federal plan with leadership, I expect 1-4 more hammers until a vaccine is developed, unless they get tired of it, fire Fauci, and decide to go for the "unmitigated disaster" plan.
On the plus side, we don't just need a US company to develop a vaccine -- if *any* country develops one, it could help. That increases the possibilities that someone could get lucky in a slightly shorter timeline. If one of the earliest candidates work, some people (healthcare workers, the dying, and the very wealthy) could be getting doses before the end of the year, so maybe someday there will be some for the rest of us.
RE: What's the end game here? - stupac2 - 03-28-2020
(03-28-2020, 02:57 PM)M T Wrote: I reach into my freezer & take out a box of frozen beans that had been coughed on by someone that was sick 3 months earlier.
Then you're fine, the virus degrades after at most 72 hours.
RE: What's the end game here? - Goose - 03-28-2020
(03-28-2020, 03:07 PM)Snorlax94 Wrote: People who think "The Dance" is going to work -- Has anyone seen any signs of any of these things in the US?Welcome to the club. I have been asking this question for at least a week in my various posts.
In a MercuryNews interview with Sara Cody, she said of Wuhan-style contact tracing:
“We can’t use that same strategy” due to short staffing, said Cody. “Trying to map and figure out where are some hotspots for transmission — we really don’t have the data to enable us to do that. That’s still a pretty fuzzy part of the picture.”
Quote:"All" America has to do is:I can't agree at all with you logic. I do agree that the Federal Government is not at all prepared to do contact tracing, testing, and mitigation in Santa Clara County. I do agree with essentially all you have said about the response at the federal level, particularly the POTUS. However, the USPHS was never tasked or funded to do nationwide pandemic contact tracing in every state and county. It has always been a county responsibility. The fact that Santa Clara County (and the other counties) can't do it isn't on the POTUS, whoever that is. It is on the Board of Supervisors and Sara Cody. If she has a plan but doesn't have a budget, speak up. I think she will get what she wants at this point. Any federal response at this point would take too long to organize. It needs to be grass roots or it isn't happening.
<snip>
IMHO, the counties should be training up all firemen and police, including auxiliaries, as fast as they can to do this work. Pay overtime as needed and use computer based training (which I am pretty sure already exists) to do it in order to do as much social distancing as possible. If that isn't enough people, ask Newsom to detail as many National Guard MPs as he can spare to be trained. Don't use medical people, because they may be needed elsewhere. Do what we need to do, but don't just sit there waiting on somebody else to save us. "They" can't do so even if they were well led. The Bay Area Counties have already shown they can cooperate by a joint declaration for shelter-in-place. They should establish an agreement to share contact information. We aren't helpless, but we have to realize that it is up to Santa Clara County to take care of Santa Clara County. We may get a little help from the State and money from the Federal Government, but that's all we are going to get.
RE: What's the end game here? - chrisk - 03-28-2020
Seniors and people with serious underlying conditions need to get the vaccine first. They could be required to show proof of vaccination to be allowed to enter buildings.
Here is an article on how China is using health codes on phones to allow people to move around now. Stores, buildings, and businesses require people to show their green code to be allowed to enter.
https://www.japantimes.co.jp/news/2020/03/24/asia-pacific/china-green-light-alipay-app/#.Xn_VHIhKhPY
RE: What's the end game here? - oldalum - 03-28-2020
(03-28-2020, 03:38 PM)Goose Wrote: IMHO, the counties should be training up all firemen and police, including auxiliaries, as fast as they can to do this work.seems like for some time we're going to have a lot of unemployed people who could use a (gov't-funded) job. Many of whom might have verifiable immunity to the virus after having had it.
RE: What's the end game here? - Goose - 03-28-2020
(03-28-2020, 04:03 PM)oldalum Wrote:Yes, but we need to have people who know something about/have experience with dealing with the public. We also need this activity to be professionally executed. Using it as WPA/CCC program probably won't accomplish that. We also need to start training now, as hopefully our "lockdown" isn't going to last six months.(03-28-2020, 03:38 PM)Goose Wrote: IMHO, the counties should be training up all firemen and police, including auxiliaries, as fast as they can to do this work.seems like for some time we're going to have a lot of unemployed people who could use a (gov't-funded) job. Many of whom might have verifiable immunity to the virus after having had it.
RE: What's the end game here? - 2006alum - 03-28-2020
(03-28-2020, 03:20 PM)stupac2 Wrote:I don't think this is entirely true. In general, coronaviruses have been shown to survive for up to two years at frozen or sub-frozen temperatures:(03-28-2020, 02:57 PM)M T Wrote: I reach into my freezer & take out a box of frozen beans that had been coughed on by someone that was sick 3 months earlier.
Then you're fine, the virus degrades after at most 72 hours.
[tweet]https://twitter.com/TraceeGuibord/status/1243476221561843713?s=20[/tweet]
Here's some more from a more reputable source:
[tweet]https://twitter.com/COVIDResponse/status/1244042995101360133?s=20[/tweet]
This suggests as long as 9 days at room temperature, so I suspect much longer at freezing temperatures.
RE: What's the end game here? - Snorlax94 - 03-28-2020
(03-28-2020, 03:38 PM)Goose Wrote: However, the USPHS was never tasked or funded to do nationwide pandemic contact tracing in every state and county. It has always been a county responsibility. The fact that Santa Clara County (and the other counties) can't do it isn't on the POTUS, whoever that is. It is on the Board of Supervisors and Sara Cody. If she has a plan but doesn't have a budget, speak up. I think she will get what she wants at this point. Any federal response at this point would take too long to organize. It needs to be grass roots or it isn't happening.I think it's an interesting idea to have local services help, and maybe they can, but I still think there needs to be leadership at a federal level.
IMHO, the counties should be training up all firemen and police, including auxiliaries, as fast as they can to do this work...
If historically, this is not something that the USPHS has been tasked with, then it needs to be changed. There's a significant motive to fix things. That is part of the leadership vacuum.
People at the local level probably can be trained to help, but it needs coordination from the top.
There are 3,007 counties in the United States. Should each of those 3,007 counties develop their own contact tracing software? Should each of them design their own websites and data sharing capabilities? From a software perspective, you'll have 3,007 different data formats, with different definitions for each label. You'll have 3,007 different training procedures for workers. Many smaller, poorer counties will be starting with very little.
If there's an outbreak in Santa Clara County, which moves to San Francisco, then later to the Central Valley, then to Las Vegas, there won't be enough knowledge sharing. Firemen in Reno will be starting from scratch even though there's a team with experience in the Bay Area. That's why it's so effective that China was able to send 1,500 epidemiologist to Wuhan, afterwards, they can move them wherever there is a new outbreak, and they'd take all that experience and hard-won knowledge with them.
Other things, like making more N95 masks isn't something a county really can do. I don't think Sara Cody can show up at CISCO and demand they start making N95 masks. It's not like Sara Cody can demand more companies build more ventilators, nor can she single-handedly move America's testing capabilities up to South Korea's.
I do share your frustration that there appears to be a learned helplessness and lack of entrepreneurship at every level of government. Even though I don't think Sara Cody can or should single-handedly increase N95 mask production or approve new ways of running tests, I think SCC *needs* her to step up and create a county capability unlike any other. And Governor Newsom runs the 10th largest economy in the world. He, like others in CA and NY, should simply expect that no help is coming. The state has the ability to do a lot more on its own. Even if CA only tried to solve these problems at a state level, it would make Californians' lives better, and would also help the country. It might even show an example to the POTUS of what a real leader is supposed to do.
RE: What's the end game here? - Goose - 03-28-2020
(03-28-2020, 04:32 PM)Snorlax94 Wrote: I think it's an interesting idea to have local services help, and maybe they can, but I still think there needs to be leadership at a federal level.It isn't an "interesting idea". It is how it is planned to work, and there are lots of reasons for that. Concentrating all the expertise and capability at the Federal level is a prescription for ensuring this kind of failure to respond. Under the current plan the USPHS is responsible for coordinating the response and for enforcing the "Federal Quarantine" (which it looks like they are about to have to do around NY and NJ). The reasons we have a local police force and a County Sheriff are the same ones that require an effective City and County health department. Federal police don't know that El Camino intersects Page Mill Road. Contact tracing in a country of 320 million people and 3.5 million square miles is not efficiently done by a central agency. This was proven during previous epidemics and the long fight against TB.
If historically, this is not something that the USPHS has been tasked with, then it needs to be changed.
Quote:There's a significant motive to fix things. That is part of the leadership vacuum.Yes, their is a leadership vacuum, and that is exactly why it is not wise to put all our eggs in that basket. If there is a single point of failure, and it fails, then what?
Quote:People at the local level probably can be trained to help, but it needs coordination from the top.Only people at the local level can do the work. If you want the USPHS to do it, they would need a detachment in each county all the time ready to go when we need them. If the Senator from Kentucky cuts the budget, we get one guy on a motor scooter. At one time, the USPHS was a much bigger organization (relatively) than it is now. Even then, the States had TB facilities of their own, as did many counties.
Quote:There are 3,007 counties in the United States. Should each of those 3,007 counties develop their own contact tracing software? Should each of them design their own websites and data sharing capabilities? From a software perspective, you'll have 3,007 different data formats, with different definitions for each label. You'll have 3,007 different training procedures for workers. Many smaller, poorer counties will be starting with very little.Which is fine until the 1500 aren't enough. The you are SOL, because there is nobody else. We have actually used that model in the US recently, where the USPHS has backstopped the local resources in small outbreaks of disease. It works great until it doesn't work at all, because there are no more resources available. This is an old argument about the "correct" sharing of activities between County, State and Federal governments. Our police departments seem to function fine without massive federal oversight. They are smart enough and self-interested enough to avoid the stupidities you outlined above. Yes, we need an FBI, but it doesn't catch speeders or burglars. I for one do not want our response to all problems to require POTUS or Congress make good decisions and good plans. We are now seeing what happens if they don't and if we allow our local capabilities to atrophy.
If there's an outbreak in Santa Clara County, which moves to San Francisco, then later to the Central Valley, then to Las Vegas, there won't be enough knowledge sharing. Firemen in Reno will be starting from scratch even though there's a team with experience in the Bay Area. That's why it's so effective that China was able to send 1,500 epidemiologist to Wuhan, afterwards, they can move them wherever there is a new outbreak, and they'd take all that experience and hard-won knowledge with them.
Quote:Other things, like making more N95 masks isn't something a county really can do. I don't think Sara Cody can show up at CISCO and demand they start making N95 masks. It's not like Sara Cody can demand more companies build more ventilators, nor can she single-handedly move America's testing capabilities up to South Korea's.Sara Cody can't protect the USA. There are powers she doesn't have. The USPHS can and should exist, and does have a regulatory, R&D, and coordination function to fulfill. They aren't ready for what is happening. FWIW, we want the surrounding counties to have a capability equal to what Santa Clara County has, because if they don't it will make Sara Cody's job harder. However, as much as I feel the POTUS is <fill in appropriate comments here>, that isn't the problem. Our national public health system at all levels isn't prepared for what's happening. It needs to get prepared in a hurry, and to do so every level has to up their game RTFN.
I do share your frustration that there appears to be a learned helplessness and lack of entrepreneurship at every level of government. Even though I don't think Sara Cody can or should single-handedly increase N95 mask production or approve new ways of running tests, I think SCC *needs* her to step up and create a county capability unlike any other. And Governor Newsom runs the 10th largest economy in the world. He, like others in CA and NY, should simply expect that no help is coming. The state has the ability to do a lot more on its own. Even if CA only tried to solve these problems at a state level, it would make Californians' lives better, and would also help the country. It might even show an example to the POTUS of what a real leader is supposed to do.
RE: What's the end game here? - stupac2 - 03-28-2020
(03-28-2020, 04:22 PM)2006alum Wrote: I don't think this is entirely true. In general, coronaviruses have been shown to survive for up to two years at frozen or sub-frozen temperatures:
[tweet]https://twitter.com/TraceeGuibord/status/1243476221561843713?s=20[/tweet]
Here's some more from a more reputable source:
[tweet]https://twitter.com/COVIDResponse/status/1244042995101360133?s=20[/tweet]
This suggests as long as 9 days at room temperature, so I suspect much longer at freezing temperatures.
This suggests 72 hours max: https://hub.jhu.edu/2020/03/20/sars-cov-2-survive-on-surfaces/
It's possible that lower temperatures slow it down, but probably not by a factor of 300. Also keep in mind that there's a large difference between "there's detectable virons at time t" and "you can get sick from the remaining virons at time t". The study suggesting 72 hours is actually the latter.
In fact, according to this exhaustively researched guide to covid food safety there haven't been any documented cases of transmission from surfaces. Is it possible? Sure. Is it likely? Not particularly.
And, really, that makes sense. People keep talking about how transmissible this is, but it's still 1 case leading to at most 3.5 more. If it could linger for days on surfaces and anyone who touched that same surface was getting sick, that number would be a lot higher. Transmission is by far the most likely from sharing close quarters, where you're guaranteed to be breathing in the carrier's exhalations.
RE: What's the end game here? - JustAnotherFan - 03-28-2020
(03-28-2020, 07:48 PM)stupac2 Wrote: And, really, that makes sense. People keep talking about how transmissible this is, but it's still 1 case leading to at most 3.5 more. If it could linger for days on surfaces and anyone who touched that same surface was getting sick, that number would be a lot higher. Transmission is by far the most likely from sharing close quarters, where you're guaranteed to be breathing in the carrier's exhalations.
I'm sorry, but can you get it from simply breathing in air from a carrier? What I've read is that there needs to be droplets, i.e., coughing or sneezing, and that simply breathing the same air is insufficient. I know there is moisture in the air we exhale but would that carry the virus and is that sufficient enough to catch the infection? I don't know and now I need to know.
RE: What's the end game here? - Snorlax94 - 03-28-2020
(03-28-2020, 07:57 PM)JustAnotherFan Wrote:The video I posted on another thread (of a professor of infectious diseases in Korea) answers these questions. My read is that he said generally no, but the case of that church superspread was exceptional because people were singing and yelling in close quarters, in an enclosed space, for hours.(03-28-2020, 07:48 PM)stupac2 Wrote: And, really, that makes sense. People keep talking about how transmissible this is, but it's still 1 case leading to at most 3.5 more. If it could linger for days on surfaces and anyone who touched that same surface was getting sick, that number would be a lot higher. Transmission is by far the most likely from sharing close quarters, where you're guaranteed to be breathing in the carrier's exhalations.
I'm sorry, but can you get it from simply breathing in air from a carrier? What I've read is that there needs to be droplets, i.e., coughing or sneezing, and that simply breathing the same air is insufficient. I know there is moisture in the air we exhale but would that carry the virus and is that sufficient enough to catch the infection? I don't know and now I need to know.