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Implementing containment measures - breaking quarantine and flattening the curve

T_R_Oglodyte

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A story from the Seattle Times that illustrates practical difficulties. For background, King County bought an EconoLodge motel that was on the market for use as a quarantine facility. So they put a homeless person there who had been exposed and was likely showing symptoms (or else they wouldn't have been tested).


But the key element in the story in the story is the simple impossibility of maintaining quarantine or isolation of the numbers of people where that would be needed. We are not going to contain. We need to flatten the curve.

flatten-curve.gif
 

T_R_Oglodyte

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As you consider your personal reaction/response in these times, please ask yourself - will this help flatten the curve? That's really the key question. Prevention and containment are not realistic. But what is key is slowing it down.

*********

Elsewhere I posted about cancelling one upcoming trip. A key part of my calculus was asking myself whether making the trip would help flatten the curve. Since I live in the Seattle area that underlies almost every decision I make these days.

I went to Costco today. Was I flattening the curve? It wasn't a straightforward decision. I have had a very slight sore throat for a couple of weeks - it's the residual of a bug I picked up in Mexico in February. I've been monitoring my temperature several times per day, and I've always been below 98 °F (my normal oral temperature is somewhere between 97.7 and 98.5 °F). I've been messaging almost daily with my health care provider. Yesterday my temp picked up slightly, but then dropped back down to normal (<98 °F) range. Simultaneously my cough also disappeared. so I have no longer have symptoms of an illness that didn't have any likely corona virus connection in the first place.

And self-distancing is a normal for me. I'm self-employed. I seldom have any physical interaction with anyone outside my family. Not the same for other family members. DW is a school teacher - a vulnerable occupation. I decided that in our family I was the best person to make a Costco run, since there was pretty much no reason to believe that I had any type of exposure. And having made that run we are now in position to isolate for up to a month (provided utility services continue).

*********

My best friend has received a kidney donation. We normally get together for a couple of hours once a week. Since he is on immune-suppressants to prevent rejection, I don't know if we should continue to get together. Fortunately, he is a retired physician/internist, so he can make that call better than I can. I'm going to insist that he wear a mask, except that I'm sure he is wearing one as a normal course anyway.

But thinking about him - this is terrifying for him and his wife and family.
 
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stmartinfan

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I cancelled a flight to Phoenix that I was planning for today. I was going to visit my sister, but she's over 80 with asthma and other health issues and I decided I didn't want to risk exposing her should I pick up the virus on the flight. Now just hoping she doesn't get exposed from another source. She's the kind of person who would find it hard to fight the infection.
 

T_R_Oglodyte

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I cancelled a flight to Phoenix that I was planning for today. I was going to visit my sister, but she's over 80 with asthma and other health issues and I decided I didn't want to risk exposing her should I pick up the virus on the flight. Now just hoping she doesn't get exposed from another source. She's the kind of person who would find it hard to fight the infection.
Yeah - I altered itinerary on one upcoming trip to eliminate a visit with my older sister (she and her husband are in their late 70s). I will likely cancel the trip entirely in the end, but for now dropping that leg of the trip was an easy risk reducer.
 

Panina

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Sadly there will be people that will not quarantine when they should or when they test positive. There should be a law if you are under ordered quarantine you can get prosecuted if you break it.
 

T_R_Oglodyte

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Sadly there will be people that will not quarantine when they should or when they test positive. There should be a law if you are under ordered quarantine you can get prosecuted if you break it.
For years I've had a sentiment that we have been so successful in disease prevention over the last century that most people living today in first and second world countries have lost touch with the reality of disease.

People are freaking about COVID-19, but in the history of world pandemics this is pretty minor. People have no memory of the Plague. Cholera and typhoid, Diphtheria. Smallpox I'm old enough to have a few memories of polio and iron lungs.

IMO - if we want to make lemon drops out of lemons, one result of the COVID-19 episode will be a wake-up call to many people that life isn't fair. it's cruel, it's harsh, and it doesn't give a damn about how unfairly you think you have been treated throughout your life.

And maybe then we will be ready to deal with something that truly might kill most of us. But then one of the lessons of history is how people fail to learn from the lessons and thus are condemned to repeat the errors of history.
 

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Very interesting article in today's WSJ about S. Korea's policies to COVID-19 vs. Italy and how citizens' reactions in each country are very much related to cultural norms.

And building on the previous comment -- COVID 19 also is a lesson to many , particularly teens & children that "disappointment" is a normal part of life and you sometimes have to experience it. And you won't die from disappointment.
 

isisdave

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I seriously think that no more than 1% of the country's population has given as much thought to this as has T_R.

Someone should make a documentary of the situation in Lombardy, and force all networks to play it three nights in a row.

We should ramp up supermarket delivery or pickup service, waive all fees for it, and charge admission to grocery stores, or maybe issue ration tickets that permit in-person shopping.

All those teenagers who are unexpectedly getting a 3-week break can volunteer to run errands and make pickups for the elderly and immune-compromised.

Bring more ideas how to improve lemon-drop production ....
 

T_R_Oglodyte

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I seriously think that no more than 1% of the country's population has given as much thought to this as has T_R.

Someone should make a documentary of the situation in Lombardy, and force all networks to play it three nights in a row.

We should ramp up supermarket delivery or pickup service, waive all fees for it, and charge admission to grocery stores, or maybe issue ration tickets that permit in-person shopping.

All those teenagers who are unexpectedly getting a 3-week break can volunteer to run errands and make pickups for the elderly and immune-compromised.

Bring more ideas how to improve lemon-drop production ....
And shut down all bars and restaurants. Oh wait - Illinois and Ohio just did that!

Re economic issues, I think this is going to cause some significant restructuring of the retail industry. Namely, many people who don't routinely use door-delivery services are going to start using them out of necessity. And after this ends, they will continue using those services. So going forward I think there will be an increased shift to those services. Which means that many people who are currently involved in retail operations will find themselves working logistics and delivery instead of store operations.
 
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geekette

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Sadly there will be people that will not quarantine when they should or when they test positive. There should be a law if you are under ordered quarantine you can get prosecuted if you break it.
that would seriously hamper those of us with underlying conditions that live alone. please reconsider. Not allowing me to take a walk, even with mask, seems excessively punitive and bad for my mental health.
 

Panina

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that would seriously hamper those of us with underlying conditions that live alone. please reconsider. Not allowing me to take a walk, even with mask, seems excessively punitive and bad for my mental health.
In my township there are volunteers to get what those need that are home bound, leaving it outside the door. Hopefully every township has that, or one can order online or they have family or friends that can order for them if they are not computer savvy.

My mom is just getting over being sick. She wanted to go out today to get drugstore items she need. She lives in NYC. I told her not to just in case she is getting over the virus she can spread it to others. I ordered for her online to be delivered to her home.

I understand how bad lots of this is for mental health for many including those that live with others. If you are sick, unless you are going to get tested or going to the doctor imo you should stay home as you can spread it to others.
 

geekette

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In my township there are volunteers to get what those need that are home bound, leaving it outside the door. Hopefully every township has that, or one can order online or they have family or friends that can order for them if they are not computer savvy.

My mom is just getting over being sick. She wanted to go out today to get drugstore items she need. She lives in NYC. I told her not to just in case she is getting over the virus she can spread it to others. I ordered for her online to be delivered to her home.

I understand how bad lots of this is for mental health for many including those that live with others. If you are sick, unless you are going to get tested or going to the doctor imo you should stay home as you can spread it to others.
your original post was prosecute anyone that breaks quarantine. That's incredibly harsh and unnecessary.

Probably wouldn't come to Q as testing isn't really happening and even when it is, so many of us will be sick that there won't be those township volunteers if there is a Q as it would be them, too. They could also be bringing the virus to my door, sick and not know it, because they weren't tested. I also would prefer these volunteers help people much worse off than I am.

heck yeah, stay home if you're sick! I've been staying home healthy! But I cannot be ok with arresting people doing what they need to do to survive, go quickly and safely about it, and tuck in back home. It's bad use of precious resources and exposing cops unnecessarily.

The way I look at it, we're all on our honor to do our best for all of us. I do my stuff in the middle of the night, can go through self check and anybody noticing my mask knows to spray that station and cart down on my departure.
 

rapmarks

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In our neighborhood, the Care Bears have volunteered to run errands, but they are as old as most of us. We were joking if they quarantine anyone over 70, we know a few 60 year olds to run errands
 

Panina

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your original post was prosecute anyone that breaks quarantine. That's incredibly harsh and unnecessary.

Probably wouldn't come to Q as testing isn't really happening and even when it is, so many of us will be sick that there won't be those township volunteers if there is a Q as it would be them, too. They could also be bringing the virus to my door, sick and not know it, because they weren't tested. I also would prefer these volunteers help people much worse off than I am.

heck yeah, stay home if you're sick! I've been staying home healthy! But I cannot be ok with arresting people doing what they need to do to survive, go quickly and safely about it, and tuck in back home. It's bad use of precious resources and exposing cops unnecessarily.

The way I look at it, we're all on our honor to do our best for all of us. I do my stuff in the middle of the night, can go through self check and anybody noticing my mask knows to spray that station and cart down on my departure.
You just showed the reason it will keep spreading. Many will do what they want, not what the professionals suggest. They will give themselves a reason it is okay to do otherwise. I was not harsh, it is the reality to get the peak flattened to save lives of those that are in the most jeopardy.

 

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You just showed the reason it will keep spreading. Many will do what they want, not what the professionals suggest. They will give themselves a reason it is okay to do otherwise. I was not harsh, it is the reality to get the peak flattened to save lives of those that are in the most jeopardy.

You missed the part where I have been home since Feb 26. How many others here can say that? I have heard lots of shopping shopping shopping, but I haven't. I still have the same pack of toilet paper that was here from Feb 26. same soap, sanitizer. I wasn't in any lines around the building. I wasn't at the airport.

Healthy, avoiding exposure the best I can. I am absolutely doing my part. It is seriously unlikely that I will ever get tested, let alone quarantined as by then it wouldn't make any sense. I will probably get sick, stay home, it will pass. I have been aiming for far end of the curve for a long time, hoping to be of service to those more infirm than I in my neighborhood.

I do my deal in the middle of the night, the big 24 hour store. I don't linger, I get my crap, I go. If I were actually quarantined, sure, I'd call ahead for the bag at the curb to swing by and pick up. I like that bag in my car more than I like it in a car of anyone else. Me and my germs have been avoiding as much as possible whatever everyone else is already getting. Me in my private car should not alarm anyone that steps away from the curb as I pull up. arrest me if you will.
 

T_R_Oglodyte

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your original post was prosecute anyone that breaks quarantine. That's incredibly harsh and unnecessary.

Probably wouldn't come to Q as testing isn't really happening and even when it is, so many of us will be sick that there won't be those township volunteers if there is a Q as it would be them, too. They could also be bringing the virus to my door, sick and not know it, because they weren't tested. I also would prefer these volunteers help people much worse off than I am.

heck yeah, stay home if you're sick! I've been staying home healthy! But I cannot be ok with arresting people doing what they need to do to survive, go quickly and safely about it, and tuck in back home. It's bad use of precious resources and exposing cops unnecessarily.

The way I look at it, we're all on our honor to do our best for all of us. I do my stuff in the middle of the night, can go through self check and anybody noticing my mask knows to spray that station and cart down on my departure.
You just showed the reason it will keep spreading. Many will do what they want, not what the professionals suggest. They will give themselves a reason it is okay to do otherwise. I was not harsh, it is the reality to get the peak flattened to save lives of those that are in the most jeopardy.

Santayana's comment to the effect that that those who don't learn the lessons of history are condemned to repeat it's mistakes seems appropriate. The clear lesson from multitudes of past disease outbreaks is that there is a number of people who will engage in dangerous behavior and for the good the community they must be stopped. If someone has a predilection for killing people indiscrminately with a firearm, we stop them. If someone indiscriminately infects other people with HIV, we stop them. If someone indiscriminately targets laser beams in the eyes of people flying airplanes, we stop them.
 

Panina

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You missed the part where I have been home since Feb 26. How many others here can say that? I have heard lots of shopping shopping shopping, but I haven't. I still have the same pack of toilet paper that was here from Feb 26. same soap, sanitizer. I wasn't in any lines around the building. I wasn't at the airport.

Healthy, avoiding exposure the best I can. I am absolutely doing my part. It is seriously unlikely that I will ever get tested, let alone quarantined as by then it wouldn't make any sense. I will probably get sick, stay home, it will pass. I have been aiming for far end of the curve for a long time, hoping to be of service to those more infirm than I in my neighborhood.

I do my deal in the middle of the night, the big 24 hour store. I don't linger, I get my crap, I go. If I were actually quarantined, sure, I'd call ahead for the bag at the curb to swing by and pick up. I like that bag in my car more than I like it in a car of anyone else. Me and my germs have been avoiding as much as possible whatever everyone else is already getting. Me in my private car should not alarm anyone that steps away from the curb as I pull up. arrest me if you will.
You missed my point. I am talking about sick people who know they are sick and do not follow orders to self quarantine and put others in danger.
 

dsmrp

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Flattening the curve should reduce the number of infections, but I think just as importantly it spreads out & slows the number of cases needing hospitalization and intensive support measures over time, so that our current healthcare system can hopefully better handle demand. I'm in the same locale as the OP, and the county hospital which serves the un-insured community was pre-Covid-19, usually operating at 95-99% capacity.

The virus is already in the community. Even with social distancing and quarantines, we're not going to eliminate it. The infection rates are only going to go up, primarily because availability of testing is not widespread yet. I think there is a good amount of the infected iceberg below the water line that we just don't have hard numbers yet. It's the known unknown.

Btw, the person the OP mentioned who left the quarantine facility, fortunately had their COVID test result come back negative.
 
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geekette

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You missed my point. I am talking about sick people who know they are sick and do not follow orders to self quarantine and put others in danger.
I still can't see my way to arrest unless we're talking about wanton disregard, like sick person goes around kissing people on the lips, intentionally getting into elevators and coughing.., or, worst of all, frequenting retirement homes or going to food service job.
heck yeah, if we're talking about That kind of behavior, malicious? I think, however, we will not have sufficient tracking to actually know who does that. Anyone that knows of such behavior can, in my opinion, do whatever they must to isolate that person, cops or not. locked in a basement works for me. Just don't go into cruel detainment, or the law comes for the detainer. We're all in this together, I'll help tackle him.

I am certain that we've had sick people walking around for weeks, test only makes it certain. Cat is well out of the bag. I can't fault a guy that heads to Walgreen's at midnight because his wife and toddler need cold medicine or pain reliever, just wear the mask, sanitize hands before entering store. Sure, if they have someone that will make that trip for them at midnight, that's great. Most of us don't. I would risk arrest to make that trip for my elderly or cancer-stricken neighbors (most everyone here well older than me). I'm ok being seen as a bad guy while trying to do the right thing.

We do still have a lot of folks that don't get flu shot, so we aren't stopping that, either. I think some people are going to get double whammy, flu then corona, vice versa. Some people sick today don't know if they have flu or corona, and if they don't get Quite Sick, they may never know. I do not at all believe that we have under 20 positives in my state. I have been assuming everyone else has it and doesn't know it, and so do I.

I'm in favor of as little misery to as few people as possible.
 

easyrider

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I was watching the news and it occurred to me that if this virus situation was an action disaster type movie we would be about 15 - 20 minutes in.

Bill
 
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