03-28-2020, 02:57 PM
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.
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.