[dabigv13]

https://www.nytimes.com/2020/08/28/world...k-69696398

SF and San Diego can reopen indoor dining next week.

Hopefully we take it slow this time. Socal hospitalizations and ICU seem to be at the levels of their nadir after the first spike. As long as people keep the proper mindset I think we can slowly reopen safely.

[dabigv13]

https://www.nytimes.com/2020/08/28/world...k-69696398

SF and San Diego can reopen indoor dining next week.

Hopefully we take it slow this time. Socal hospitalizations and ICU seem to be at the levels of their nadir after the first spike. As long as people keep the proper mindset I think we can slowly reopen safely.

[akiddoc]

I don't think there is really any safe way to reopen. As businesses open up, cases will increase, followed by death. It comes down to deciding what death rate is acceptable. 

In my new job (2 weeks in) in the heart of Oakland poverty, the rate of Covid positive tests is stunning. Many homes house a large number of people, and one person catching the virus leads to almost 100% of household members getting infected. I'm also amazed by the lack of respiratory symptoms among the Covid positive children I am dealing with. The most common symptom is fever, followed in second by diarrhea, then by headache. Cough is rare.

Of the 7,000 people tested by the clinic, 1500 have been positive.

[akiddoc]

I don't think there is really any safe way to reopen. As businesses open up, cases will increase, followed by death. It comes down to deciding what death rate is acceptable. 

In my new job (2 weeks in) in the heart of Oakland poverty, the rate of Covid positive tests is stunning. Many homes house a large number of people, and one person catching the virus leads to almost 100% of household members getting infected. I'm also amazed by the lack of respiratory symptoms among the Covid positive children I am dealing with. The most common symptom is fever, followed in second by diarrhea, then by headache. Cough is rare.

Of the 7,000 people tested by the clinic, 1500 have been positive.

[DocSavage87]

I don't think there is really any safe way to reopen. As businesses open up, cases will increase, followed by death. It comes down to deciding what death rate is acceptable. 

In my new job (2 weeks in) in the heart of Oakland poverty, the rate of Covid positive tests is stunning. Many homes house a large number of people, and one person catching the virus leads to almost 100% of household members getting infected. I'm also amazed by the lack of respiratory symptoms among the Covid positive children I am dealing with. The most common symptom is fever, followed in second by diarrhea, then by headache. Cough is rare.

Of the 7,000 people tested by the clinic, 1500 have been positive.

Ugh.  Do we have an idea what transmission rate is from an infected person to family members?  I though it was much lower than 100% and one of the hypotheses for this was cross-reactive T-cell immunity.  What are the best studies on this issue? It also seems that family transmission could vary quite a bit based on socioeconomic conditions. Many families have no effective way of isolating a sick family member, especially in a packed household where multiple people must work in high-exposure jobs.

[DocSavage87]

I don't think there is really any safe way to reopen. As businesses open up, cases will increase, followed by death. It comes down to deciding what death rate is acceptable. 

In my new job (2 weeks in) in the heart of Oakland poverty, the rate of Covid positive tests is stunning. Many homes house a large number of people, and one person catching the virus leads to almost 100% of household members getting infected. I'm also amazed by the lack of respiratory symptoms among the Covid positive children I am dealing with. The most common symptom is fever, followed in second by diarrhea, then by headache. Cough is rare.

Of the 7,000 people tested by the clinic, 1500 have been positive.

Ugh.  Do we have an idea what transmission rate is from an infected person to family members?  I though it was much lower than 100% and one of the hypotheses for this was cross-reactive T-cell immunity.  What are the best studies on this issue? It also seems that family transmission could vary quite a bit based on socioeconomic conditions. Many families have no effective way of isolating a sick family member, especially in a packed household where multiple people must work in high-exposure jobs.

[Goose]

It also seems that family transmission could vary quite a bit based on socioeconomic conditions.  Many families have no effective way of isolating a sick family member, especially in a packed household where multiple people must work in high-exposure jobs.

For sure it is and has been. Take a look at
https://www.smchealth.org/health-officer...-statement

No matter what one thinks about the causes of this non compliance, it appears that it has very significantly impacted the ability of San Mateo County to mitigate the epidemic by tracking and tracing. It appears they have somewhat given up. I have been trying to get clarification on this issue, but my county supervisor has been kind of busy with 50% of his district evacuated. I will restart the effort on Monday.

[Goose]

It also seems that family transmission could vary quite a bit based on socioeconomic conditions.  Many families have no effective way of isolating a sick family member, especially in a packed household where multiple people must work in high-exposure jobs.

For sure it is and has been. Take a look at
https://www.smchealth.org/health-officer...-statement

No matter what one thinks about the causes of this non compliance, it appears that it has very significantly impacted the ability of San Mateo County to mitigate the epidemic by tracking and tracing. It appears they have somewhat given up. I have been trying to get clarification on this issue, but my county supervisor has been kind of busy with 50% of his district evacuated. I will restart the effort on Monday.

[dabigv13]

I think enough people have internalized that this is not something that will dissappear, and that requires vigilance, that places will reopen with better safety measures, and customers will be more uniformly masked. And I think most areas of CA are not ready to move ahead, like Newsom. But as long as this trajectory holds, maybe we'll get to "Europe after first wave" levels by end of September, and then it would make sense to loosen a few things.

[dabigv13]

I think enough people have internalized that this is not something that will dissappear, and that requires vigilance, that places will reopen with better safety measures, and customers will be more uniformly masked. And I think most areas of CA are not ready to move ahead, like Newsom. But as long as this trajectory holds, maybe we'll get to "Europe after first wave" levels by end of September, and then it would make sense to loosen a few things.

[DocSavage87]

It also seems that family transmission could vary quite a bit based on socioeconomic conditions.  Many families have no effective way of isolating a sick family member, especially in a packed household where multiple people must work in high-exposure jobs.

For sure it is and has been. Take a look at
https://www.smchealth.org/health-officer...-statement

No matter what one thinks about the causes of this non compliance, it appears that it has very significantly impacted the ability of San Mateo County to mitigate the epidemic by tracking and tracing. It appears they have somewhat given up. I have been trying to get clarification on this issue, but my county supervisor has been kind of busy with 50% of his district evacuated. I will restart the effort on Monday.

That health officer said, "Try getting compliance with isolation and quarantine when the infected person is the breadwinner for the family and the family will be out on the street if they don’t go to work. "

One of the things that stood out to me about the Swedish situation is a national law granting 2 weeks of sick pay to everyone, and with the pandemic, the gov't stepped up to make sure the pay is 100% salary and no doctor's note is necessary anymore.  They've made it much easier for the breadwinner to stay home when infected. There's also some relief if the sickness lasts more than 14 days as well.

[DocSavage87]

It also seems that family transmission could vary quite a bit based on socioeconomic conditions.  Many families have no effective way of isolating a sick family member, especially in a packed household where multiple people must work in high-exposure jobs.

For sure it is and has been. Take a look at
https://www.smchealth.org/health-officer...-statement

No matter what one thinks about the causes of this non compliance, it appears that it has very significantly impacted the ability of San Mateo County to mitigate the epidemic by tracking and tracing. It appears they have somewhat given up. I have been trying to get clarification on this issue, but my county supervisor has been kind of busy with 50% of his district evacuated. I will restart the effort on Monday.

That health officer said, "Try getting compliance with isolation and quarantine when the infected person is the breadwinner for the family and the family will be out on the street if they don’t go to work. "

One of the things that stood out to me about the Swedish situation is a national law granting 2 weeks of sick pay to everyone, and with the pandemic, the gov't stepped up to make sure the pay is 100% salary and no doctor's note is necessary anymore.  They've made it much easier for the breadwinner to stay home when infected. There's also some relief if the sickness lasts more than 14 days as well.

[Mick]

I don't think there is really any safe way to reopen. As businesses open up, cases will increase, followed by death. It comes down to deciding what death rate is acceptable. 

Well, I really want that haircut badly, so i signed up anyway...

[Mick]

I don't think there is really any safe way to reopen. As businesses open up, cases will increase, followed by death. It comes down to deciding what death rate is acceptable. 

Well, I really want that haircut badly, so i signed up anyway...

[Goose]

It also seems that family transmission could vary quite a bit based on socioeconomic conditions.  Many families have no effective way of isolating a sick family member, especially in a packed household where multiple people must work in high-exposure jobs.

For sure it is and has been. Take a look at
https://www.smchealth.org/health-officer...-statement

No matter what one thinks about the causes of this non compliance, it appears that it has very significantly impacted the ability of San Mateo County to mitigate the epidemic by tracking and tracing. It appears they have somewhat given up. I have been trying to get clarification on this issue, but my county supervisor has been kind of busy with 50% of his district evacuated. I will restart the effort on Monday.

That health officer said, "Try getting compliance with isolation and quarantine when the infected person is the breadwinner for the family and the family will be out on the street if they don’t go to work. "

One of the things that stood out to me about the Swedish situation is a national law granting 2 weeks of sick pay to everyone, and with the pandemic, the gov't stepped up to make sure the pay is 100% salary and no doctor's note is necessary anymore.  They've made it much easier for the breadwinner to stay home when infected.  There's also some relief if the sickness lasts more than 14 days as well.

I think San Mateo County could do that. However, I think the problems are that 1) there is no way the infected person can isolate at home. There isn't enough room, and 2) there are other people in the household that want/need to go to work. They aren't sick (yet), but they are exposed and should quarantine. They won't do that, and getting economic coverage for those people from the county will be a hard sell, at best.  There are too many people involved and they don't have COVID-19 (so far as we know). On top of that, many people in this situation want nothing to do with the government in any form. They may be perfectly "legal", but others in and around the household may not be. Not worth the risk. That precludes sending them all to a hotel to quarantine, even if the facilities were made available. That is why SMC Health is so frustrated.

[Goose]

It also seems that family transmission could vary quite a bit based on socioeconomic conditions.  Many families have no effective way of isolating a sick family member, especially in a packed household where multiple people must work in high-exposure jobs.

For sure it is and has been. Take a look at
https://www.smchealth.org/health-officer...-statement

No matter what one thinks about the causes of this non compliance, it appears that it has very significantly impacted the ability of San Mateo County to mitigate the epidemic by tracking and tracing. It appears they have somewhat given up. I have been trying to get clarification on this issue, but my county supervisor has been kind of busy with 50% of his district evacuated. I will restart the effort on Monday.

That health officer said, "Try getting compliance with isolation and quarantine when the infected person is the breadwinner for the family and the family will be out on the street if they don’t go to work. "

One of the things that stood out to me about the Swedish situation is a national law granting 2 weeks of sick pay to everyone, and with the pandemic, the gov't stepped up to make sure the pay is 100% salary and no doctor's note is necessary anymore.  They've made it much easier for the breadwinner to stay home when infected.  There's also some relief if the sickness lasts more than 14 days as well.

I think San Mateo County could do that. However, I think the problems are that 1) there is no way the infected person can isolate at home. There isn't enough room, and 2) there are other people in the household that want/need to go to work. They aren't sick (yet), but they are exposed and should quarantine. They won't do that, and getting economic coverage for those people from the county will be a hard sell, at best.  There are too many people involved and they don't have COVID-19 (so far as we know). On top of that, many people in this situation want nothing to do with the government in any form. They may be perfectly "legal", but others in and around the household may not be. Not worth the risk. That precludes sending them all to a hotel to quarantine, even if the facilities were made available. That is why SMC Health is so frustrated.

[BostonCard]

In the meantime, in South Korea...

https://www.latimes.com/world-nation/sto...osecutions

Now, he sits in jail awaiting trial, accused of impeding epidemiological investigators. He faces up to two years in prison and has become a cautionary tale in a nation well-versed in vigilance and shame. His name has not been released as is typical for criminal cases in South Korea.

Not posting this as a roadmap.  I would want people to cooperate, but out of a sense of joint purpose, not out of fear of being thrown in jail.

With regard to breadwinners getting put into quarantine, you would think we could pay people identified as contacts to stay at home and not infect others.

BC

[BostonCard]

In the meantime, in South Korea...

https://www.latimes.com/world-nation/sto...osecutions

Now, he sits in jail awaiting trial, accused of impeding epidemiological investigators. He faces up to two years in prison and has become a cautionary tale in a nation well-versed in vigilance and shame. His name has not been released as is typical for criminal cases in South Korea.

Not posting this as a roadmap.  I would want people to cooperate, but out of a sense of joint purpose, not out of fear of being thrown in jail.

With regard to breadwinners getting put into quarantine, you would think we could pay people identified as contacts to stay at home and not infect others.

BC

[fullmetal]

SF and San Diego can reopen indoor dining next week.

Just in time for Labor Day weekend...yikes.

[fullmetal]

SF and San Diego can reopen indoor dining next week.

Just in time for Labor Day weekend...yikes.

[Goose]

Not posting this as a roadmap.  I would want people to cooperate, but out of a sense of joint purpose, not out of fear of being thrown in jail.

Me too. I would also like people to not steal or drive while drunk out of a sense of joint purpose. Most people in fact do that. Unfortunately, there are always some who do not. That group of people needs the fear of being thrown in jail AND the opprobrium of their fellow citizens IMHO.

With regard to breadwinners getting put into quarantine, you would think we could pay people identified as contacts to stay at home and not infect others.



BC

As I read it, the guy in Korea had tested positive and lied/forgot about his contacts. Such actions are obviously problematic to containing the disease. If done willfully, it must be punished, IMHO. This is not criminalizing the disease. Getting COVID-19 is not the issue. Not cooperating with contact tracing is. I suspect that many people working in the "gig" economy don't want to admit to their contacts because they aren't paying taxes on the income/don't have appropriate licenses etc. This is probably true in both Korea and the USA. While county health probably isn't going to follow up on such violations anyway, people may chose to lie out of an abundance of caution. Providing an immediate disincentive to such activity that county health IS going to follow up on is needed to overcome that kind of reasoning.

As far as paying salary  to people who have no sick leave, who test positive and must isolate, I think that is something that would receive wide public support. I also think providing a place where they could isolate if necessary would receive public support. Keeping somebody who tests positive out of circulation is such a "win" that making the case to do so is pretty easy.

Doing the same with contacts that need to quarantine is a bit harder sell, because the public needs to be convinced that paying people who are not sick (yet) pays off. If we knew what percentage of contacts actually do end up testing positive, and that number was publicly available, that might help with selling the idea, especially if that percentage is large. Another question is how many contacts per unit time are we talking about? Since nobody is releasing that number, how can the public know what kind of expenditure we are talking about here? Naturally, if the number of cases is small, and the number of contacts is small, the expense of doing such payments becomes much easier to sell. If you can argue that the high initial expense will be rapidly reduced by declining case counts, it is a much easier sell. OTOH, if that doesn't happen, the public will quickly say "no" to such payments, IMHO.

As pointed out by SMC Health, contacts (and "cases") that do not want anything to do with the government are also a real problem. They won't sign up to take the money if offered and will continue to work/live normally.

[Goose]

Not posting this as a roadmap.  I would want people to cooperate, but out of a sense of joint purpose, not out of fear of being thrown in jail.

Me too. I would also like people to not steal or drive while drunk out of a sense of joint purpose. Most people in fact do that. Unfortunately, there are always some who do not. That group of people needs the fear of being thrown in jail AND the opprobrium of their fellow citizens IMHO.

With regard to breadwinners getting put into quarantine, you would think we could pay people identified as contacts to stay at home and not infect others.



BC

As I read it, the guy in Korea had tested positive and lied/forgot about his contacts. Such actions are obviously problematic to containing the disease. If done willfully, it must be punished, IMHO. This is not criminalizing the disease. Getting COVID-19 is not the issue. Not cooperating with contact tracing is. I suspect that many people working in the "gig" economy don't want to admit to their contacts because they aren't paying taxes on the income/don't have appropriate licenses etc. This is probably true in both Korea and the USA. While county health probably isn't going to follow up on such violations anyway, people may chose to lie out of an abundance of caution. Providing an immediate disincentive to such activity that county health IS going to follow up on is needed to overcome that kind of reasoning.

As far as paying salary  to people who have no sick leave, who test positive and must isolate, I think that is something that would receive wide public support. I also think providing a place where they could isolate if necessary would receive public support. Keeping somebody who tests positive out of circulation is such a "win" that making the case to do so is pretty easy.

Doing the same with contacts that need to quarantine is a bit harder sell, because the public needs to be convinced that paying people who are not sick (yet) pays off. If we knew what percentage of contacts actually do end up testing positive, and that number was publicly available, that might help with selling the idea, especially if that percentage is large. Another question is how many contacts per unit time are we talking about? Since nobody is releasing that number, how can the public know what kind of expenditure we are talking about here? Naturally, if the number of cases is small, and the number of contacts is small, the expense of doing such payments becomes much easier to sell. If you can argue that the high initial expense will be rapidly reduced by declining case counts, it is a much easier sell. OTOH, if that doesn't happen, the public will quickly say "no" to such payments, IMHO.

As pointed out by SMC Health, contacts (and "cases") that do not want anything to do with the government are also a real problem. They won't sign up to take the money if offered and will continue to work/live normally.