Coronavirus pandemic

[kalvado]

Over the past 7 weeks Arizona's test positivity rate has risen from 6.5% on May 16th to 25.9% on July 4th yet deaths over the same period has remained relatively flat.  Arizona has a similar population to Massachusetts and their test positivity rate peaked in April at 29.4%.  When compared to Massachusetts outbreak, i'd expect Arizona to be averaging well over 100 deaths a day at this point but last check they were only average 31 deaths a day.  I get that deaths lag new cases, but to this degree?  Was there a massive outbreak in Massachusetts nursing homes that we just aren't seeing in Arizona?  There has to be a reason why not as many people are dying in Arizona's outbreak.

Nurising homes can be a big part of it.
Another reason is well summed in this article: https://www.physiciansweekly.com/update-mortality-rate-of-covid-19-patients-on-ventilators/

Data released on May 8 by the UK's Intensive Care National Audit & Research Centre (ICNARC) shows the mortality rate for 4287 COVID 19 patients who received advanced respiratory support was 58.8%. This figure is much lower than percentages of 86% to 97% as reported in earlier studies included in my March 30 post on this topic.

Basically doctors learned a thing or two about how to deal with the virius

[J N Winkler]

It also matters if growth in cases follows an exponential pattern.  If it does, it is just a matter of time before your ICUs are clogged with young covid-19 patients, even if you are 100% successful at keeping the virus out of congregate settings involving the elderly and other high-risk groups.

[tradephoric]

It also matters if growth in cases follows an exponential pattern.  If it does, it is just a matter of time before your ICUs are clogged with young covid-19 patients, even if you are 100% successful at keeping the virus out of congregate settings involving the elderly and other high-risk groups.

Arizona was experiencing exponential growth in new cases from May 26th through June 23rd.  The exponential growth has been tapering off over the past 2 weeks suggesting Arizona may be near the peak of their outbreak.  But you would have expected to see increased deaths associated with the exponential rise in cases but we largely haven't seen that.  I've been pointing out the low deaths in Arizona for weeks now and deaths just continue to remain fairly flat (in fact over the past 3 days average daily deaths have been declining). 


https://aatishb.com/covidtrends/?scale=linear&region=US&doublingtime=3&location=Arizona&location=Massachusetts


https://aatishb.com/covidtrends/?scale=linear&data=deaths&region=US&doublingtime=3&location=Arizona&location=Massachusetts

[kphoger]

it should also be remembered that the six-foot/two-meter rule was rather arbitrarily set, based on a study of a cough. 

This.

It has amazed me how everybody and their uncle has latched onto the six-foot rule.  It was based on a decades-old study that measured the distance large-droplet spray was likely to travel.  This coronavirus is capable of traveling on much smaller droplets, yet nobody seems to have any issue with keeping the "safe" distance at six feet.

There's also the fact that asking people to stand 9-15 feet apart would start to get impractical very fast.

This is true for many situations, but not all.

It also matters if growth in cases follows an exponential pattern.  If it does, it is just a matter of time before your ICUs are clogged with young covid-19 patients, even if you are 100% successful at keeping the virus out of congregate settings involving the elderly and other high-risk groups.

And I think we're seeing that where you and I live.  The data below is little bit out of date because I made these files on Friday night, but they illustrate steeper slopes now than ever before.

[kphoger]

Depending on how loosely you define the word "know", my wife and I now know someone who has tested positive.  It is the relative of a customer of my wife's MLM business.  We've met him once, maybe twice.  I'm kind of surprised it's taken this long for us to personally know someone who's tested positive.

[kalvado]

it should also be remembered that the six-foot/two-meter rule was rather arbitrarily set, based on a study of a cough. 

This.

It has amazed me how everybody and their uncle has latched onto the six-foot rule.  It was based on a decades-old study that measured the distance large-droplet spray was likely to travel.  This coronavirus is capable of traveling on much smaller droplets, yet nobody seems to have any issue with keeping the "safe" distance at six feet.

It works the same with diets - plainly being aware of situation is doing a lot. 6' may be worse than 20', but better than nothing - and 20' is often impossible to begin with.
After all, R0 was about 2 at the beginning - it's not like thing spreads at a blink of an eye. SOME reduction of transmission should be enough to keep things in check, and increasing recommended distance may actually make things worse 

[NWI_Irish96]

We have a family vacation planned for August 3-9, already postponed once from June. Trip is supposed to be to New England, but Massachusetts is requiring a 14 day quarantine upon entering the state, so that pretty much kills the trip. We hate to postpone again, as we are running up against the start of the school year and eventually risk losing our airline credit.

Is there any city that meets all of the following criteria:
1) At least 400 miles from Chicago (worth the effort to fly instead of drive)
2) Has non-stop flights on Southwest from Midway (not doing layovers, no exceptions)
3) Has no restrictions on people traveling from IL/IN
4) Has enough tourist destinations within a 3-hour drive that are open to justify going there for a week

[Roadgeekteen]

We have a family vacation planned for August 3-9, already postponed once from June. Trip is supposed to be to New England, but Massachusetts is requiring a 14 day quarantine upon entering the state, so that pretty much kills the trip. We hate to postpone again, as we are running up against the start of the school year and eventually risk losing our airline credit.

Is there any city that meets all of the following criteria:
1) At least 400 miles from Chicago (worth the effort to fly instead of drive)
2) Has non-stop flights on Southwest from Midway (not doing layovers, no exceptions)
3) Has no restrictions on people traveling from IL/IN
4) Has enough tourist destinations within a 3-hour drive that are open to justify going there for a week

NY/NJ/CT only has restrictions for certain states, and I don't think that Illinois is one of them.

[NWI_Irish96]

We have a family vacation planned for August 3-9, already postponed once from June. Trip is supposed to be to New England, but Massachusetts is requiring a 14 day quarantine upon entering the state, so that pretty much kills the trip. We hate to postpone again, as we are running up against the start of the school year and eventually risk losing our airline credit.

Is there any city that meets all of the following criteria:
1) At least 400 miles from Chicago (worth the effort to fly instead of drive)
2) Has non-stop flights on Southwest from Midway (not doing layovers, no exceptions)
3) Has no restrictions on people traveling from IL/IN
4) Has enough tourist destinations within a 3-hour drive that are open to justify going there for a week

NY/NJ/CT only has restrictions for certain states, and I don't think that Illinois is one of them.

The New England states, save CT, are the only lower 48 states I haven't been to and I was really wanting to get them all on the same trip. I guess if no better options emerge, we can modify our trip to exclude the Boston portion and then maybe just cross into MA for a few minutes to get the state on a technicality.

[Roadgeekteen]

We have a family vacation planned for August 3-9, already postponed once from June. Trip is supposed to be to New England, but Massachusetts is requiring a 14 day quarantine upon entering the state, so that pretty much kills the trip. We hate to postpone again, as we are running up against the start of the school year and eventually risk losing our airline credit.

Is there any city that meets all of the following criteria:
1) At least 400 miles from Chicago (worth the effort to fly instead of drive)
2) Has non-stop flights on Southwest from Midway (not doing layovers, no exceptions)
3) Has no restrictions on people traveling from IL/IN
4) Has enough tourist destinations within a 3-hour drive that are open to justify going there for a week

NY/NJ/CT only has restrictions for certain states, and I don't think that Illinois is one of them.

The New England states, save CT, are the only lower 48 states I haven't been to and I was really wanting to get them all on the same trip. I guess if no better options emerge, we can modify our trip to exclude the Boston portion and then maybe just cross into MA for a few minutes to get the state on a technicality.

I mean Massachusetts isn't really enforcing the rules so you should be good if you don't stay at any lodging. Just make sure to wear a mask when out in public.

[Scott5114]

it should also be remembered that the six-foot/two-meter rule was rather arbitrarily set, based on a study of a cough. 

This.

It has amazed me how everybody and their uncle has latched onto the six-foot rule.  It was based on a decades-old study that measured the distance large-droplet spray was likely to travel.  This coronavirus is capable of traveling on much smaller droplets, yet nobody seems to have any issue with keeping the "safe" distance at six feet.

It's generally the case the farther the distance, the less viral load is transmitted. So you have to find a distance that is far enough to curb transmission, but not so far away that it becomes impractical, since there would be less compliance with a ten-foot rule or a twenty-foot rule. There's also a point at which you're likely to experience diminishing returns. Six feet is efficacious while still being reasonably practical, so that's been the consensus recommendation.

There's also the benefit that six feet is a distance that the human brain is better at estimating, because it happens to be close to the height of a human male. It is easy to picture someone lying down on the floor as a mental measuring tape. If the recommended distance were, say, eight feet, that'd be more difficult.

[RobbieL2415]

We have a family vacation planned for August 3-9, already postponed once from June. Trip is supposed to be to New England, but Massachusetts is requiring a 14 day quarantine upon entering the state, so that pretty much kills the trip. We hate to postpone again, as we are running up against the start of the school year and eventually risk losing our airline credit.

Is there any city that meets all of the following criteria:
1) At least 400 miles from Chicago (worth the effort to fly instead of drive)
2) Has non-stop flights on Southwest from Midway (not doing layovers, no exceptions)
3) Has no restrictions on people traveling from IL/IN
4) Has enough tourist destinations within a 3-hour drive that are open to justify going there for a week

Honestly your best bet would be to take a couple extra days and drive to your destination. That way you avoid the solicitation of the quarantine at the airport.

[NWI_Irish96]

We have a family vacation planned for August 3-9, already postponed once from June. Trip is supposed to be to New England, but Massachusetts is requiring a 14 day quarantine upon entering the state, so that pretty much kills the trip. We hate to postpone again, as we are running up against the start of the school year and eventually risk losing our airline credit.

Is there any city that meets all of the following criteria:
1) At least 400 miles from Chicago (worth the effort to fly instead of drive)
2) Has non-stop flights on Southwest from Midway (not doing layovers, no exceptions)
3) Has no restrictions on people traveling from IL/IN
4) Has enough tourist destinations within a 3-hour drive that are open to justify going there for a week

Honestly your best bet would be to take a couple extra days and drive to your destination. That way you avoid the solicitation of the quarantine at the airport.

We're specifically trying to use airline tickets that are going to expire.

[kphoger]

That image is obviously not testing SARS-CoV-2.

The fact that respiratory bacteria, attached to large droplets, fall down to the ground within six feet does not mean that SARS CoV-2 viruses, which are able to attach to smaller droplets, necessarily follow the same pattern.

Diameter of SARS-CoV-2 (virus) = 0.1 μm
Diameter of streptococcus pneumoniae (bacterium) = 0.5 to 1.25 μm
Length of streptococcus pyogenes chains (bacterial coccus) = 0.5 mm

[Scott5114]

So what?

[MikeTheActuary]

NY/NJ/CT only has restrictions for certain states, and I don't think that Illinois is one of them.

And, FWIW, Illinois is only roughly half-way to the criteria NY/NJ/CT are using.  If it doesn't get much worse there....

We have a family vacation planned for August 3-9, already postponed once from June. Trip is supposed to be to New England, but Massachusetts is requiring a 14 day quarantine upon entering the state, so that pretty much kills the trip. We hate to postpone again, as we are running up against the start of the school year and eventually risk losing our airline credit.

Is there any city that meets all of the following criteria:
1) At least 400 miles from Chicago (worth the effort to fly instead of drive)
2) Has non-stop flights on Southwest from Midway (not doing layovers, no exceptions)
3) Has no restrictions on people traveling from IL/IN
4) Has enough tourist destinations within a 3-hour drive that are open to justify going there for a week

At the moment, BDL has one daily nonstop to/from MDW...although the schedule sucks.

You'd technically still have to avoid MA, RI, VT, NH, and ME under current rules...but I'm uncertain as to how well the rules are enforced...but NYC is within the specified radius by car or by train.

In CT most attractions are open or are opening soon, albeit with some restrictions for the obvious reason.  State parks and forests have been seeing heavy use as well, to the point that there have been closures for capacity reasons.  Bars and nightclubs are the only businesses that are still universally closed (although most white-collar offices are still ordered to do WFH to the greatest extent practical).

There are likely other sources that can better report on the tourist situation in NYC.

CT's positivity rate was running below 1% and trending down the last I checked...but that could have course change between now and then (c.f. my remarks elsewhere on lack of distancing/masks over the Fourth).


Another place that fits your criteria is Memphis, which is perhaps a bit too open given the COVID trends there.   If you stretch the 3 hour time limit, you could split the week between Memphis and Nashville (although I haven't confirmed the status of MDW-BNA).

Do your tickets expire before Labor Day?  Southwest's timetable really sucks right now with all the service cutbacks.  However, after Labor Day, the timetables currently look more normal, potentially giving you more options.

[Brandon]

This kind of backs up tradephoric's numbers, with a lot of links in the article.

As COVID-19 Cases Surge, Daily Deaths and the Case Fatality Rate Continue To Fall

In Texas, newly confirmed cases rose 13-fold, from 623 to 8,258, between May 25 and July 4 before falling to 3,449 yesterday. The number had risen six-fold as of two weeks ago, and by now that increase should be having an impact on daily deaths. Yet the rolling seven-day average of daily deaths has risen only modestly since Memorial Day, from 26 to 32. Meanwhile, the crude case fatality rate for Texas, which peaked at 3.4 percent on April 30, has continued to fall, reaching 0.5 percent yesterday.

"So far," The New York Times notes, "the death toll has not climbed much in Texas and other parts of the South and West seeing a surge." Even taking into account the increase in cases during the last two weeks, Youyang Gu's epidemiological model projects that daily deaths in Texas will rise to a peak of 64 in mid-to-late August before declining to 52 by the end of September. That's a substantial increase but not at all commensurate with the spike in cases.

One of the arguments for lockdowns was that delaying cases would reduce the ultimate death toll by buying time for improvements like these. That may indeed be what happened, although the extent to which lockdowns actually reduced virus transmission is a matter of much debate. Cellphone and foot traffic data show that Americans were practicing social distancing before they were legally required to do so and started moving around more before lockdowns were lifted.

Gu's estimates likewise show that the COVID-19 reproductive number–the number of people infected by the average carrier–was falling before states started imposing lockdowns, although that policy may have reinforced the preexisting trend in some places. As of yesterday, according to his model, the reproductive number in California was 1.1, compared to 1.07 in Texas and Florida.

As recently as May 4, The New York Times was warning that the United States could see 3,000 COVID-19 deaths a day by June 1, thanks to "reopening the economy." That is 12 times the current level and four times the number Gu is projecting for late August.

For the record, Gu's model has been fairly good at predicting both what has happened, and seems to be happening, rather well. https://covid19-projections.com/us

[NWI_Irish96]

NY/NJ/CT only has restrictions for certain states, and I don't think that Illinois is one of them.

And, FWIW, Illinois is only roughly half-way to the criteria NY/NJ/CT are using.  If it doesn't get much worse there....

We have a family vacation planned for August 3-9, already postponed once from June. Trip is supposed to be to New England, but Massachusetts is requiring a 14 day quarantine upon entering the state, so that pretty much kills the trip. We hate to postpone again, as we are running up against the start of the school year and eventually risk losing our airline credit.

Is there any city that meets all of the following criteria:
1) At least 400 miles from Chicago (worth the effort to fly instead of drive)
2) Has non-stop flights on Southwest from Midway (not doing layovers, no exceptions)
3) Has no restrictions on people traveling from IL/IN
4) Has enough tourist destinations within a 3-hour drive that are open to justify going there for a week

At the moment, BDL has one daily nonstop to/from MDW...although the schedule sucks.

You'd technically still have to avoid MA, RI, VT, NH, and ME under current rules...but I'm uncertain as to how well the rules are enforced...but NYC is within the specified radius by car or by train.

In CT most attractions are open or are opening soon, albeit with some restrictions for the obvious reason.  State parks and forests have been seeing heavy use as well, to the point that there have been closures for capacity reasons.  Bars and nightclubs are the only businesses that are still universally closed (although most white-collar offices are still ordered to do WFH to the greatest extent practical).

There are likely other sources that can better report on the tourist situation in NYC.

CT's positivity rate was running below 1% and trending down the last I checked...but that could have course change between now and then (c.f. my remarks elsewhere on lack of distancing/masks over the Fourth).


Another place that fits your criteria is Memphis, which is perhaps a bit too open given the COVID trends there.   If you stretch the 3 hour time limit, you could split the week between Memphis and Nashville (although I haven't confirmed the status of MDW-BNA).

Do your tickets expire before Labor Day?  Southwest's timetable really sucks right now with all the service cutbacks.  However, after Labor Day, the timetables currently look more normal, potentially giving you more options.

The tickets don't expire before Labor Day, but the kids start back to school August 14, and unless we decide to skip family Christmas activities, aren't going to have a full week we can go anywhere with the kids before they do expire.

[Duke87]

Regardless, the whole thing is a bunch of security theater anyway. Last night the mayor of Hoboken was on TV making noise about how "even if you have been tested and tested negative you still have to quarantine for 14 days". Why? You afraid people are going to spread a disease it was just confirmed they don't have?
Indeed, this creates a perverse incentive for people to not go and get tested after returning from travel, in order to avoid having any questions asked.

Because negative test doesn't mean " confirmed they don't have virus".

Not literally, no, since false negatives are a thing, but it provides enough confidence that the cost/benefit of placing the individual under house arrest for two weeks is no longer there.
You want to encourage people to get tested after traveling, and waving the carrot of being exempt from quarantine requirements if you test negative is a great way to do this.

It's also ridiculous in that it depends purely on what state a person traveled to with no regard for what a person did while there. Spent a week camping in the middle of the desert in Arizona? Quarantine for you! Went barhopping every night in Wisconsin? You're free to go about your business!

it should also be remembered that the six-foot/two-meter rule was rather arbitrarily set, based on a study of a cough. 

This.

It has amazed me how everybody and their uncle has latched onto the six-foot rule.  It was based on a decades-old study that measured the distance large-droplet spray was likely to travel.  This coronavirus is capable of traveling on much smaller droplets, yet nobody seems to have any issue with keeping the "safe" distance at six feet.

I think it's best understood probabilisticly. No, it's not the case that standing 5'11" from someone infected is guaranteed to get you sick while standing 6'1" from the same person is guaranteed to not. Rather, there is a risk curve which starts very high immediately adjacent to someone and then decreases with increasing distance. It is not zero after six feet, but it is low enough to be deemed acceptable.

And yes it's true that small droplets can carry further, but it does still logically follow that the point at which the big droplets have fallen away is a point at which that risk will see a notable drop. Better to only be exposed to small droplets than to both small and large ones.

Over the past 7 weeks Arizona's test positivity rate has risen from 6.5% on May 16th to 25.9% on July 4th yet deaths over the same period has remained relatively flat.  Arizona has a similar population to Massachusetts and their test positivity rate peaked in April at 29.4%.  When compared to Massachusetts outbreak, i'd expect Arizona to be averaging well over 100 deaths a day at this point but last check they were only average 31 deaths a day.  I get that deaths lag new cases, but to this degree?  Was there a massive outbreak in Massachusetts nursing homes that we just aren't seeing in Arizona?  There has to be a reason why not as many people are dying in Arizona's outbreak.

Methinks this is a factor of who is getting infected. Back in March/April there were a lot of outbreaks in nursing homes, i.e. highly vulnerable populations. Now, we're not seeing that - the surge in cases are being driven predominately by people going to crowded bars, house parties, etc. These are activities which are disproportionately partaken in by younger people, i.e. less vulnerable populations.

[SEWIGuy]

I think it's clear that we are getting better at treating this too which is why death rates haven't increased. Hospitalizations are still a problem though.

[vdeane]

So is anyone else already making big plans for when the pandemic ends?

Nope.  I've learned better. 

I'm probably to blame for the pandemic.  I was SO proud of myself, getting nice and organized, and getting travel plans in place for most of the year very early on.  Given how I shuttle among CT, QC, and TN, I've found that if I lock in "defensible" travel dates, I can usually get work and my father's doctors to accommodate my already-made travel plans....and for 2020 I had those plans made in such a way that I wouldn't wear myself out with back-to-back  (or back-to-back-to-back) trips.

And then the pandemic went and made all those plans moot.  I don't know when the US/Canadian border will reopen, so it's pointless for me to plan to go to QC, and I don't know when my father's assisted living will be open for visitors / when Connecticut will stop requiring people arriving from Tennessee to quarantine upon arrival.  So, in a couple of weeks, I will be able to say "I haven't spent this much time in one place in my memory/probably in my life."

Pre-pandemic, I had 4-5 trips queued up:

• Fly to Denver, and drive a loop CO»WY»SD»ND»MT»ID»OR»ID»UT»CO, to set foot in the 6 states in the lower 48 that I still lack.
  
• Operate the one of the CQWW radio contests from Sept-ÃŽles, QC
  
• Drive up to the Lac-Saint-Jean region of Québec
  
• Drive QC138 out to Kegasha
  
• Cruise, probably to the southern Caribbean

Those are still "on the list", although I'm becoming more inclined to drop the cruise and just fly to someplace and simply "be unplugged" for a week or two, and I'm tempted to add a cross-country rail trip after having watched a few YouTube videos.

If that's the case, then I'm to blame too.  I also had the whole year planned out already (and a good chunk of next year).  I also remember wishing really hard that something would be done about the traffic on the Thruway that had been getting worse every year until recently.  Well, I've had no complaints about Thruway this year.  I guess I should be careful what I wish for.

[LM117]

[kphoger]

[img

That image is obviously not testing SARS-CoV-2.

The fact that respiratory bacteria, attached to large droplets, fall down to the ground within six feet does not mean that SARS CoV-2 viruses, which are able to attach to smaller droplets, necessarily follow the same pattern.

Diameter of SARS-CoV-2 (virus) = 0.1 μm
Diameter of streptococcus pneumoniae (bacterium) = 0.5 to 1.25 μm
Length of streptococcus pyogenes chains (bacterial coccus) = 0.5 mm

So what?

So, if this virus attaches to smaller droplets that travel farther in the air before falling to the ground, then people should stop using a number that was the result of bacteria that only attach to larger droplets which can't travel as far.  The picture you posted implies in the context of this discussion that, at six feet, there is almost no presence of SARS CoV-2 from respiratory cough spray.  However, it means no such thing, because the experiment the picture was taken from wasn't studying this virus, but rather bacteria that were substantially larger and cannot travel as far through the air.  Just because six feet might be a magic number for one germ, that doesn't make it a magic number for a different one.

But, having said that...

I think it's best understood probabilisticly ... Better to only be exposed to small droplets than to both small and large ones.

This makes sense.  A certain amount of the virus-laden droplets will have fallen away at six feet, even if other smaller ones continue their journey through the air beyond that point.

[formulanone]

So is anyone else already making big plans for when the pandemic ends?

This is the virus that never ends
It just goes on and on, my friends
Some people started bringing it
Not knowing what it was
And they'll continue bringing it
Forever just because...

Restrictions will tail off very gradually, in the great scheme of things. I think many people had this notion that it's like opening a store at 00:00:00 on Black Friday, and that was never going to be the case. But it's going to be this hissy-fit of "winners and losers" that have more restrictions than others, and traveling is about 50% less fun right now.

[SEWIGuy]

Really I see no reason not to think that unless we start chaning our behavior soon, that this fall is going to be a disaster.  People in the north are going to start heading back indoors, and there will be numerous outbreaks tied to schools and colleges.