Seanly asked a good set of questions in comments yesterday:
- If we’re mostly staying at home, how is the virus still spreading so much? Is it that even with restrictions there are still some people spreading it? Seems the odds of that happening would decrease? Is it possible there are some people who are asymptomatic carriers (like for weeks)?
- at some point we will have to open things up a bit more (not now, not so fast). I’m not sure what that will look like. We’re going to still need some food production, still need to get teeth cleaned, and may need pants. How & when can we do this?
- Weren’t there some experts who thought the way to proceed with effective testing, tracing, etc is that we’d have the country mostly open (with masks & social distancing) and then if a hotspot bloomed only that area would need the stricter lockdown?
#1 Yesterday, Scott Gottlieb in Congressional testimony estimated the (R)eproductive number is currently about 1.1. 1.1 R means that for every 100 people who are currently infectious with COVID, they will infect, on average about 110 new people. Other sources have the national R at or a smidge under 1. All of these estimates have large confidence intervals.
Infection is not occurring randomly. Instead we are seeing clustering of new infections and clustering of non-infections. New infections are happening disproportionally in places where isolation and distancing do not readily or easily occur. This means nursing homes, assisted living centers, slaughterhouses, prisons, jails, detention centers and aircraft carriers are seeing virgin field, rapid spread outbreaks. Indoor spaces with prolonged proximity and lots of aerosol exchanges are prime locations for hot spots.
#2 Building on #1, a recognition that indoor spaces with high density of interactions is a very bad thing allows us to shape the environment and our monitoring to lower risk. North Carolina is slowly re-opening in phases with the intention of keeping density of interactions and personal proximity low even as stores that have been closed for 7-8 weeks restore some degree of service. Florists can probably have a decent chance of safely re-opening while sit-down dining at Red Lobster is far more questionable in terms of risk management.
Duke University has been slowly planning to bring a small cadre of workers back on campus for a few weeks. I fully expect that I won’t be allowed on campus until July. I expect that I will be encouraged to work at home for the rest of the year as a means of minimizing on-campus interaction density. No one needs a life saving blog post or a critical revise and resubmit.
#3 Yeah, that is my boss’s plan. The hope is that the baseline rate of spread is low enough that a hot spot can be quickly identified and then smothered. South Korea is doing that now. They had a micro-hotspot in Seoul’s bars. They tested
2,000 20,000 or more people and isolate plenty of folks so that the hot spot could not light the rest of the city on fire again. That is the suppression model that has a chance in hell of working until there is a vaccine while keeping the economy mostly open.