Coronavirus pandemic

[RobbieL2415]

Couple quick takes:

1) How is TX going to realistically enforce a mandatory quarantine for folks travelling by car from CT, NJ, NY or RI?  I get that that's a minority of travelers but the virus can still spread that way?

2) There's no way to enforce any executive order limiting travel if you're driving because you would have to already be breaking a traffic law to get pulled over.

Law is always a last resort.  You would hope that people wouldn't steal because it's wrong.  After that, you would hope that people wouldn't steal because they don't want anyone to steal from them.  For the most reprobate, you need laws, so that people won't steal because they don't want to be punished.  If I'm under an order to stay home and leave only for essential purposes and I go to a store, no one is going to search my home to verify that I legitimately needed to go to a store.  But we should expect that people will behave responsibly and not put other people in danger.  This is similar to the language in TxDOT's speed limit guidance, which doesn't say that speed limits are absolute, but says that the purpose of speed limits is to inform drivers of what speed is safe for the roads.  We then hope that drivers will take the guidance seriously.  The enforcement is the hope that you don't want to contribute to the harm and death of other people.  If you don't care about that, then only the most draconian laws can stop you.

I'm more getting at the fact that it only takes one person to infect many others.

[Duke87]

1) How is TX going to realistically enforce a mandatory quarantine for folks travelling by car from CT, NJ, NY or RI? 

They're not - the mandatory quarantine only applies if you arrive by air (it also doesn't include RI).

As for how they'd enforce it, well, if you register with the state Department of Public Service as the order requires you to, they will send people to do random checks to make sure you are in what you have designated as your quarantine location and that no one else is in there with you.

If you do not register as required... I'm not sure exactly what the state has in mind, though it is worth noting that if you get on an airplane, an official record of this fact is kept by the airline. The state of Texas may be able to get access to the passenger logs for any flights arriving from the restricted areas - if they do, they can identify individuals who are out of compliance by cross-checking against who has registered with DPS.


There's also a decent chance this requirement would not hold up in court. But someone would have to be the test case, and the crisis will likely have passed by the time a grievance gets through the court system, thus rendering the matter moot.

[LM117]

604 confirmed cases in VA so far, including 5 in my area (4 in Danville, 1 in Pittsylvania County).

https://wset.com/news/coronavirus/604-cases-of-coronavirus-confirmed-in-virginia-2-in-lynchburg-4-in-danville

[webny99]

Louisiana has the 10th most cases of all US states, but the 3rd most deaths (behind only NY and WA). That's a worrying trend. It should have been clear early on that New Orleans was primed to be the #3 hot spot in the country after Seattle and NYC. It's a major cultural center, just hosted big events like Mardi Gras, is very densely populated and close-knit, has among the highest poverty rates in the nation, and the list goes on.

[bandit957]

Plus, Mardi Gras ended back when the U.S. had hardly any cases outside the Seattle area. This shows this virus has been floating around in America for months. People had it and didn't even know it.

[US71]

Plus, Mardi Gras ended back when the U.S. had hardly any cases outside the Seattle area. This shows this virus has been floating around in America for months. People had it and didn't even know it.

Possibly as early as November or December from what I'm hearing.

[Max Rockatansky]

Plus, Mardi Gras ended back when the U.S. had hardly any cases outside the Seattle area. This shows this virus has been floating around in America for months. People had it and didn't even know it.

Possibly as early as November or December from what I'm hearing.

I mentioned it upthread but I had something that matched the symptoms described in COVID-19 to a tee around Christmas.  Turns out my Wife's Cousin was feeling similarly under the weather the week before he visited us from San Diego.  One of my coworkers got sick just like I did around the same time.  The main point of emphasis everyone had was the dry cough and difficulty breathing seemed odd for a flu.

Of course now, we're all making jokes about the healing powers of Vick's...

[kalvado]

Plus, Mardi Gras ended back when the U.S. had hardly any cases outside the Seattle area. This shows this virus has been floating around in America for months. People had it and didn't even know it.

Possibly as early as November or December from what I'm hearing.

If that is indeed the case, US origin of the virus becomes a distinct possibility.

[hotdogPi]

The first several known cases were all related to travel to China. If it was in the US in December, it would have spread quickly by January, many of which would have had unknown sources.

[Max Rockatansky]

^^^

Would it not be so far fetched to say that cases could have and likely were mistaken for severe flus?  It's not anyone at the time was looking for a new viral infection..it's not all that out there considering how apathetic H1N1 was treated as just "another flu."   It would explain the plausibility of figures reported out of China since they essentially have ground to a halt. 

Plus, Mardi Gras ended back when the U.S. had hardly any cases outside the Seattle area. This shows this virus has been floating around in America for months. People had it and didn't even know it.

Possibly as early as November or December from what I'm hearing.

If that is indeed the case, US origin of the virus becomes a distinct possibility.

Is there any actual way of proving it though is the question?  People who would have recovered from the virus presumptively wouldn't test positive this far after the fact.  I suppose tests could be run on tissue samples of those who were suspected of dying from the Flu it Flu like infections. 

[bandit957]

Is there any actual way of proving it though is the question?  People who would have recovered from the virus presumptively wouldn't test positive this far after the fact.  I suppose tests could be run on tissue samples of those who were suspected of dying from the Flu it Flu like infections.

I think they just invented a serological test to see if anyone has had it and recovered. But - as with the tests for active coronavirus - excuse after excuse is being offered as to why we don't have this test in the U.S.

[kalvado]

The first several known cases were all related to travel to China. If it was in the US in December, it would have spread quickly by January, many of which would have had unknown sources.

Those are the cases that occurred after China outbreak; if the virus was spreading in US in November - it was distinctly before Chinese events
A hybrid scenario is also possible, with the virus spreading between people as relatively benign - until it mutated into a deadly form. The second event definitely happened in China,  but the original bat to human transition can become more interesting. I wonder if bats are sampled for viruses in US on a regular basis.

[kalvado]

Is there any actual way of proving it though is the question?  People who would have recovered from the virus presumptively wouldn't test positive this far after the fact.  I suppose tests could be run on tissue samples of those who were suspected of dying from the Flu it Flu like infections.

I think they just invented a serological test to see if anyone has had it and recovered. But - as with the tests for active coronavirus - excuse after excuse is being offered as to why we don't have this test in the U.S.

Those are mass produced in China. I don't think US will get too many until a profound apology for the "Chinese virus" is given. 50-year free trade agreement may be a good deal to offer...

[kalvado]

Is there any actual way of proving it though is the question?  People who would have recovered from the virus presumptively wouldn't test positive this far after the fact.  I suppose tests could be run on tissue samples of those who were suspected of dying from the Flu it Flu like infections.

Exhumation of those who died with flu-like symptoms may work as a source of RNA for PCR. For example, they could recreate the Spanish flu virus from bodies of those buried in Alaska. Yes, those were in permafrost - but it is a much longer timespan

[sprjus4]

Chesapeake Expressway (VA-168) is going AET due to COVID-19. In the meantime, most people will continue shunpiking it anyways. The road is practically dead year-round until the summer months.

CHESAPEAKE EXPRESSWAY TOLL ALERT
As an important safety measure during the COVID-19 pandemic, the Chesapeake Expressway will temporarily stop accepting cash and credit cards at the toll booths effective Friday, March 27 at noon until further notice. Tolls will still be required, but will be collected through an electronic process. For customers who do not have an E-ZPass account or use the GoToll mobile app, the toll system will capture an image of the license plate and a bill will be mailed to the registered owner of the vehicle. As part of this initiative, customers should continue driving through the toll plaza and pay attention to overhead and portable signs. Normal cash toll collection will resume as soon as it becomes safe for motorists and our staff members. Please see the information below regarding E-ZPass and the GoToll mobile app.

http://www.chesapeakeexpressway.com/

[CoreySamson]

So how long do y'all think Covid-19 will stick around for?

Last week, I guessed late April.

Now I'm guessing mid-July.

[bandit957]

So how long do y'all think Covid-19 will stick around for?

Depends on when the endless excuses about the lack of tests ends.

[vdeane]

The first several known cases were all related to travel to China. If it was in the US in December, it would have spread quickly by January, many of which would have had unknown sources.

Those are the cases that occurred after China outbreak; if the virus was spreading in US in November - it was distinctly before Chinese events
A hybrid scenario is also possible, with the virus spreading between people as relatively benign - until it mutated into a deadly form. The second event definitely happened in China,  but the original bat to human transition can become more interesting. I wonder if bats are sampled for viruses in US on a regular basis.

It's believed that patient 0 in China was infected in November, so if they infected someone who traveled to the US shortly thereafter, US transmission in late November/December is not unbelievable, especially if the article I read recently suggesting that there are a LOT more people who get this that never development symptoms than we thought (and therefore we're at a later portion of the outbreak than we think) is correct.

[US71]

So how long do y'all think Covid-19 will stick around for?

Last week, I guessed late April.

Now I'm guessing mid-July.

The Emperor says by Easter. I'm sticking close to home until the real experts say it's OK to travel. I've got lots of cleaning I can do and maybe prep some stuff for e-bay.

[thspfc]

My guess is that it will peak in late April/early May, and then begin to slow down. Of course, it might never die out all the way, it will only continue to dwindle until either a) the last infected person recovers or dies, or b) a vaccine is developed.

[J N Winkler]

Are you in the medical field?

I am not.  I have about as much expertise in medicine as the stable genius currently running things.  However, I know my way around the back of an envelope, and as this crisis has unfolded, I have done some background reading.  Our World in Data has a synopsis of COVID-19 issues from a data analysis perspective that I have personally found helpful.

Would you take my statement about 1.4 and 1.6% fatality rate as well?

This is latest published data, and it actually rings well with a few other numbers I see. Much lower for <30, suchs to be in 60+ cohort though, moreso 70+.

I would, though in all honesty I haven't followed that corner of the debate closely enough to try to referee.  The basic intuition is that the more you test, the closer your case fatality rate comes to the underlying infection fatality rate.

South Korea, AIUI, has come very close to "test everything that moves," and their percentage of over-65s is almost identical to the US'--14.42% for them versus 16.08% for us.  At the moment they have 9,332 cases and 132 deaths, which is a CFR of 1.4%.  But there is still room for their CFR to go higher because only 4,528 of the 9,332 are counted as having recovered.  I am not aware that South Korea has had to deal with ICU overload at all.

China outside Hubei has posted an overall CFR of 0.8%.  There has been some question as to whether Chinese numbers in the numerator and denominator can be trusted, but personally I think this has a lot to do with over-65s forming just 10.8% of the Chinese population.  China's overall CFR has been about 3% and the consensus is that this is partly because of ICU overload in Wuhan.

In Italy the over-65s form 23.1% of the population.  When age-stratified CFRs have been compared between China and Italy, they have been found to be almost the same up to about age 65, at which point the Italian numbers begin to be significantly higher.  This is thought to be partly because Italy has a fairly high smoking rate (24% for population as a whole, 28% for men) and also the highest prevalence of antibiotic resistance in Europe.  Since Italy has socialized medicine, but China basically does not, I think the Italian numbers may also reflect better health care allowing elders to survive longer with comorbidities, until COVID-19 comes along and kills them off.

As for us, I think we will be very lucky to achieve a CFR as low as South Korea's, not just because we are not testing nearly enough, but also because we are headed toward widespread ICU overload.

I'm not trying to be overly critical, but I feel like a ton of the issues with this country and coronavirus has been our inability to comprehend basic consequences from simple tasks like going to the gas station, or walking along a sidewalk near other people. People jogging by are putting the rest of us at risk from their excessive breathing. This is serious stuff. Think about all those people that you came into contact with during your journey, physically and verbally. Are you 100% sure that none of them had the virus? I suppose there's no way to be sure, but then that leads back to my original point: why risk it at all?

I can't speak for Kphoger, but as someone who lives in the same county he does, I wonder if your perspective is colored by Washington state being a week or two ahead of the curve in terms of measures to contain spread.  On another forum I frequent, a regular who lives in your state posted on March 4 that her husband had been instructed to work from home.

Here in Sedgwick County, the first sign I personally had that normal life was about to end was an email on March 10 from the Y advising me that they would be upgrading their sanitary measures.  I continued to exercise as normal (Monday-Wednesday-Friday schedule) through Friday, March 13.  It was not until Sunday, March 15, that the Y announced it would be closing indefinitely (reviewable daily in the first instance; they later suspended membership charges).  Although city leisure facilities (including our library and art museum) closed to the public beginning on Tuesday, March 17, and many restaurants began either closing altogether or accepting takeaway orders only, we have been on mandatory lockdown only since midnight on the night of Tuesday, March 24.

And, ultimately, I think there has been a considerable amount of spread in terms of how we, individually, have been coming to terms with what all of this means for daily life.  I think it was on March 11 (my next-to-last day at the gym) that I walked past a guy watching a wall-mounted TV in the locker room.  It was a sports channel, the chyron was saying something about league cancellations, and the man looked like he wanted to cry.

Meanwhile, on the other forum, we had a woman talking as late as March 15 about how she and her husband were in Dallas hoping to fly back to Burkina Faso (which they call home, I think because they are missionaries), and another was worrying about whether she and her husband would be able to go on a cruise with their kids and grandkids in early April (!).  I was sitting reading this and thinking, "Not gonna happen," but as this crisis has unfolded, I realize now how slow I was to understand both (1) that fighting this thing is inherently a lot harder than SARS back in 2003, and (2) the gravity of the implications of restricting testing we have been doing.

[J N Winkler]

So how long do y'all think Covid-19 will stick around for?

Last week, I guessed late April.

Now I'm guessing mid-July.

It really depends on what your chosen endpoint is.

I expect to see some relaxation of lockdowns late in the summer, depending on how effective they are in stopping further spread and allowing the health care system to catch up with backlogged cases, but I don't expect a return to full normal until there is a vaccine or a treatment (effective across all age groups) that ends the capacity of this disease to drive ICU utilization.

Wuhan has been under a strict lockdown for two months.  The ones in the West have been more porous, so they may be less effective and thus require more time to pull the basic reproduction number under unity.  Two months under lockdown from now is essentially until first of June.  How much more time beyond two months we will need has yet to be determined.

There is a growing consensus that any unwinding of lockdowns has to be buttressed by effective and widely available testing.  We can't continue testing as we have been if we want to lick this.  There has also been talk of some kind of temporary credentialing system that would allow people who have recovered from COVID-19 (and thus presumably have immunity) to undertake jobs and tasks carrying a higher risk of infection.  I am not sure we want to go in that direction because it will entail setting up a bureaucracy and risks entrenching discrimination.

[kalvado]

The first several known cases were all related to travel to China. If it was in the US in December, it would have spread quickly by January, many of which would have had unknown sources.

Those are the cases that occurred after China outbreak; if the virus was spreading in US in November - it was distinctly before Chinese events
A hybrid scenario is also possible, with the virus spreading between people as relatively benign - until it mutated into a deadly form. The second event definitely happened in China,  but the original bat to human transition can become more interesting. I wonder if bats are sampled for viruses in US on a regular basis.

It's believed that patient 0 in China was infected in November, so if they infected someone who traveled to the US shortly thereafter, US transmission in late November/December is not unbelievable, especially if the article I read recently suggesting that there are a LOT more people who get this that never development symptoms than we thought (and therefore we're at a later portion of the outbreak than we think) is correct.

The question is why it flared up much faster in Wuhan than at any other spot which saw infection earlier in the season. Wuhan flare-up is pretty well documented by now, and it is unlikely a similar process can go unnoticed elsewhere.
I still think that Wuhan being where the mutation of a milder virus took place can be a better explanation than anything else. I hear about some strange infections similar to COVID - not with COVID mortality rates, though - from friends in many countries; and from multiple corners of the US. Could be two waves from China, could be the first one originating anywhere else.
There are a few reports of human to pet transmission by now, showing that virus jumps between species, and eating massive amount of wildelife may be an unrelated issue to the case at hand.

[kwellada]

So how long do y'all think Covid-19 will stick around for?

Last week, I guessed late April.

Now I'm guessing mid-July.

I think we currently lack enough data to definitively know. 
here's an interesting article regarding various scenarios about how this plays out:
https://www.theatlantic.com/family/archive/2020/03/coronavirus-social-distancing-over-back-to-normal/608752/

I don't think we really ever get back to normal for a couple years and even then, society is going to have a shared sense of PTSD regarding what we'll have gone through.

But I do hope cases peak by June.  People need to take precautions seriously.  A friend of a friend just passed away and he was only 40.  This is deadly serious. 

[bandit957]

A couple sources said the new cases will probably peak in about 2 or 3 weeks. It's moving faster than some people thought.