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Social distancing and shelter in place - working or not?

T_R_Oglodyte

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Washington was the first area in the US to start to implement social distancing and shelter in place types of activities. That was several weeks ago, and given a 2-3 week incubation period for the virus, that means that results should be starting to show.

Below is a chart from today's (March 26) edition of the Seattle Times, showing confirmed cases over time. It's still early but evidence for effectiveness might be there. A few weeks ago, around 3/8, you see the curve progressively steeping. That's an exponential growth curve. But you can see the steepness of the curve diminish during the week of 3/8 - in fact it's almost linear before starting to accelerate again during the week of 3/15. And now we have data though 3/25.

But what is potentially significant is that between 3/15 and 3/22 the increase in cases was about 175/day. Over the last three days, the increase in cases has been 195 cases/day, While that's a slight increase from the prior week, there is a lot of "slop" in the data, so those are essentially the same number. (And, equally, that could indicate that the exponential growth phase is resuming.) If these are the same number, though, that is an arithmetic increase, not an exponential increase. More significantly, if the upward bending and accelerating trend from 3/1 to 3/15 had continued, my eyeball guess is that we would be somewhere between 5,000 and 10,000 cases.

What happens the rest of this week will be telling. If we're tracking Italy and Spain, the recent days will have just been a blip and the numbers are about to explode. If they stay down, then I think that indicates that strategies short of full quarantine may be helping to manage the curve.

1585244684949.png


What happens the rest of this week here in Washington will be telling and will have a direct impact on strategies that are followed throughout the world. If the curve reverts to some form of exponential increase, that means that far stronger measures than have been taken in Washington will be needed. If the arithmetic (or linear) increase continues, then stricter forms of social distancing than those implemented in Washington will be needed. And if the curve flattens then we will know those measures are effective, but implementing stricter measures will be needed to collapse the curve.

Stay safe and stay healthy everyone.
 
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DaveNW

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Thanks, Steve. This sort of information is helpful.

Dave
 

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Not surprisingly, the majority of the states with "stay at home" orders have the most cases such as New York and California, yet Ohio and Connecticut have fewer than 1,000 cases and are asking residents to stay home.

 

easyrider

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I hope its working. My biggest problem are my adult grand-kids living here. They were just doing what ever they wanted until a few days ago when we put the kybosh on going anywhere unnecessary. We finally said go out then stay out and now they know.

Bill
 

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T_R_Oglodyte

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Maybe they have more cases because they have larger populations?
Ohio, at least, has a significantly larger population than Washington.

It's not surprising that the biggest clusters have occurred in areas that have the most cultural and economic ties east Asia.
 

Luanne

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Ohio, at least, has a significantly larger population than Washington.

It's not surprising that the biggest clusters have occurred in areas that have the most cultural and economic ties east Asia.
He was mentioning New York and California, not Washington.
 

geoand

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Washington was the first area in the US to start to implement social distancing and shelter in place types of activities. That was several weeks ago, and given a 2-3 week incubation period for the virus, that means that results should be starting to show.

Below is a chart from today's (March 26) edition of the Seattle Times, showing confirmed cases over time. It's still early but evidence for effectiveness might be there. A few weeks ago, around 3/8, you see the curve progressively steeping. That's an exponential growth curve. But you can see the steepness of the curve diminish during the week of 3/8 - in fact it's almost linear before starting to accelerate again during the week of 3/15. And now we have data though 3/25.

But what is potentially significant is that between 3/15 and 3/22 the increase in cases was about 175/day. Over the last three days, the increase in cases has been 195 cases/day, While that's a slight increase from the prior week, there is a lot of "slop" in the data, so those are essentially the same number. (And, equally, that could indicate that the exponential growth phase is resuming.) If these are the same number, though, that is an arithmetic increase, not an exponential increase. More significantly, if the upward bending and accelerating trend from 3/1 to 3/15 had continued, my eyeball guess is that we would be somewhere between 5,000 and 10,000 cases.

What happens the rest of this week will be telling. If we're tracking Italy and Spain, the recent days will have just been a blip and the numbers are about to explode. If they stay down, then I think that indicates that strategies short of full quarantine may be helping to manage the curve.

View attachment 18276

What happens the rest of this week here in Washington will be telling and will have a direct impact on strategies that are followed throughout the world. If the curve reverts to some form of exponential increase, that means that far stronger measures than have been taken in Washington will be needed. If the arithmetic (or linear) increase continues, then stricter forms of social distancing than those implemented in Washington will be needed. And if the curve flattens then we will know those measures are effective, but implementing stricter measures will be needed to collapse the curve.

Stay safe and stay healthy everyone.
I find it interesting that our resident Troglodyte is giving a scientific explanation that makes sense
 

T_R_Oglodyte

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I find it interesting that our resident Troglodyte is giving a scientific explanation that makes sense
Thanks. Just sharing my thoughts.

Some of the leading researchers who model the spread of infectious diseases are here in Seattle, and they are looking at these data, along with scads more. Gov. Inslee and his staff have developed their responses based on input from that modeling team. The team expects to release updated information sometime this week, but I haven't seen anything yet.
 

CO skier

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But what is potentially significant is that between 3/15 and 3/22 the increase in cases was about 175/day. Over the last three days, the increase in cases has been 195 cases/day, While that's a slight increase from the prior week, there is a lot of "slop" in the data, so those are essentially the same number. (And, equally, that could indicate that the exponential growth phase is resuming.)
That is an important point. Due to inconsistencies in testing, numbers like these present only a "general idea" of where the Covid-19 infection rate may be at any given time.

The column "Tests per million people" in this linked article illustrates just one of the inconsistencies for state-to-state comparisons, as an example.

 

Passepartout

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I find it interesting that our resident Troglodyte is giving a scientific explanation that makes sense
Steve knows where to look and has a pretty analytical mind. There's also some purdy good 'puter models in his local area. Sometimes it just helps to know which rock to peek under to find the worm you're looking for.

Jim
 

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That USA Today article with maps is a bit misleading. It's not up-to-date with Nevada rules at all and neither have some other major news sites been. Here in Nevada we have:
- Campaign encouraging people to stay home
- Encouraging 6 feet apart social distancing
- Ban on groups of 10 or more if they're not from same household
- Nonessential businesses closed (or work from home) including casinos: The Las Vegas Strip is closed
- Most playgrounds, sports courts, skateparks are closed
- The big school districts are closed, libraries closed, all kinds of gov services closed or only online (kids who got free school lunches can pick up food from various locations around the valley)

---

I think we will just have to wait and see what happens. I know here in Nevada the decision to do some sort of lockdown wasn't based on the number of cases, it was based on the number of ICU beds, vents and other healthcare resources. We have about 420 cases now and 10 deaths in Nevada, far fewer than many places. But already nearly 80% of ICU rooms and over 30% of our ventilators are being used. We have a website that updates with the status of cases: https://nvhealthresponse.nv.gov/
Here is an example from yesterday: https://nvhealthresponse.nv.gov/wp-content/uploads/2020/03/3.25.20-Sit-Rep.pdf

Private businesses are collaborating with government to try to get more PPE for healthcare workers, more vents, to help alleviate the struggles of the public, and do education campaigns. Nevada isn't getting much help from the feds (I know a lot of states are not either) so my state is trying to get local businesses to help.

I feel like my state's efforts have definitely helped slow down the spread here in the Vegas area. If they hadn't shut down the Strip then I believe our capacity at the hospitals would already be overwhelmed. A friend of a friend works at one of the hospitals where tourists normally go and at first when the state lockdown began she thought it was overkill. The hospital was cleared out and nearly emptied in preparation. Now it's back to normal capacity - without tourists - and most of those patients have COVID-19. I believe if Nevada had waited another week to act, our death toll would be much higher now than it is.
 

T_R_Oglodyte

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That is an important point. Due to inconsistencies in testing, numbers like these present only a "general idea" of where the Covid-19 infection rate may be at any given time.

The column "Tests per million people" in this linked article illustrates just one of the inconsistencies for state-to-state comparisons, as an example.

Another reason to focus on just one area when reviewing data - less inconsistency.

Now the folks who are doing the modeling try to account for those inconsistencies when doing the modeling. Of course, that increases the error bands in their estimates.
 

T_R_Oglodyte

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The data for today, March 26, was close to the worst that could have been expected. Instead of a continuing flattening of the curve, today's data put us back on the exponential curve that started March 1. Unless things severely turn in the next couple of days, these data suggest that "social distancing" isn't cutting it as a measure to "flatten the curve".


1585281403355.png
 

bbodb1

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...or that social distancing was not being practiced as it should have been.

On another point that I nay have missed....does the source of the chart allow for / take into consideration increased testing?
 

pedro47

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Not surprisingly, the majority of the states with "stay at home" orders have the most cases such as New York and California, yet Ohio and Connecticut have fewer than 1,000 cases and are asking residents to stay home.

The population of the states of New York and California are much greater than Ohio and Connecticut. You can not compared a very large state to two smaller states IMO.
Examples: What is the population of the state of Ohio and Connecticut. Now
what is the population of New York City, New York and the City of Los Angles, California ?

The population for the state of Connecticut is only 3.5 million.
The population for the state of Ohio is only 11.7 million.

Current population for New York City is 8.6 million
Current population for the City of Los Angles is 4 million

Data is in the eyes of the person, who will tell you the truth of how to read the numbers correctly IMHO.
 
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Big Matt

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I don't have a lot of data to back up my claim, but if you look across the United States, it seems clear that population density is more of a factor than anything in the two largest metro areas. You see lots of cases in and around NYC (New York suburbs, New Jersey, Connecticut). A huge number of people commute into the city where there is zero concept of social distancing until the shelter in place began. The Los Angeles metro area is about 19-20 million and so is the New York City metro area. The big difference between the two metro areas is population density. NYC metro is 3450 square miles and 5318 people per square mile whereas the LA metro area is 33,950 square miles or 550 per square mile. The New York metro area has a disproportionate number of cases when comparing the density. My theory is that the more dense the population, the greater chance of transmission. This is heightened by the time of incubation relative to how we rolled out the social distancing and shelter in place recommendations.

If I'm right, we may have caught the spread early enough with social distancing and shelter in place. We may need to restrict travel in and out of high population density areas. We should reasonably know in about two more weeks for sure.
 

bogey21

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Population density is important. Here in Texas we have 3 large cities, Houston, Dallas/Fort Worth and San Antonio. Much of the rest of the state is rural or semi-rural. IMO our Governor is smart in leaving the decision how to react to the Cities...

George
 

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Well, I suppose someone has to play the role of outcast.

Understand that I'm not going to debate whether the concept of "shelter in place" works or not. Perhaps it does or perhaps it doesn't.

I have always believed and continue to believe in the United States, it's not possible to fully implement without deeply damaging the fabric of American life. The broadest versions of such orders violate fundamental constitutional rights, and may ultimately not be enforceable in a free and open society. But, that will be a matter for the courts to decide.

There was a noted infectious disease researcher by the name of Michael Osterholm who co-authored an op-ed in the Washington Post, and stated that “a national lock-down is no cure.” In the op-ed, Osterholm and co-author Mark Olshaker wrote that “we can’t have everyone stay home and still produce and distribute the basics needed to sustain life and fight the disease” and that “the best alternative will probably entail letting those at low risk for serious disease continue to work … while at the same time advising higher-risk individuals to protect themselves through physical distancing and ramping-up our health-care capacity as aggressively as possible.”

To all of those they define as "essential", I'm not going to expect them to report to work, service my needs and when finished, run home, close the door and cower in fear on the off chance they may contract a virus or for what some see as the good of society.
 

klpca

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Well, I suppose someone has to play the role of outcast.

Understand that I'm not going to debate whether the concept of "shelter in place" works or not. Perhaps it does or perhaps it doesn't.

I have always believed and continue to believe in the United States, it's not possible to fully implement without deeply damaging the fabric of American life. The broadest versions of such orders violate fundamental constitutional rights, and may ultimately not be enforceable in a free and open society. But, that will be a matter for the courts to decide.

There was a noted infectious disease researcher by the name of Michael Osterholm who co-authored an op-ed in the Washington Post, and stated that “a national lock-down is no cure.” In the op-ed, Osterholm and co-author Mark Olshaker wrote that “we can’t have everyone stay home and still produce and distribute the basics needed to sustain life and fight the disease” and that “the best alternative will probably entail letting those at low risk for serious disease continue to work … while at the same time advising higher-risk individuals to protect themselves through physical distancing and ramping-up our health-care capacity as aggressively as possible.”

To all of those they define as "essential", I'm not going to expect them to report to work, service my needs and when finished, run home, close the door and cower in fear on the off chance they may contract a virus or for what some see as the good of society.
As someone in the high risk group (autoimmune) working in a non essential role (financial services) I am not happy that I am being guilted into working because someone has decided that I am not at risk because our office is small. Sheesh, I understand my risk a lot better than someone looking in from the outside, yet here we are. My boss has "read everything" and decided that I am, in his mind, low risk and says things like, "well it's your decision but I hope that you understand that I have read up on covid-19 and you're not going to get it". Luckily I'm in CA so I just have to cite the governors decision, but even then I have had to work from the office for the last three days because of clients who need things done immediately. (Remember - financial services, not medical services. As far as I am concerned, nothing financial needs to be done immediately). After the last "immediate" need was taken care of yesterday I let him know that I am working from home for the foreseeable future. I am dreading the day that the President tells everyone to get back to work because that will be the end of me working from home. Because my boss thinks that he knows more about covid than most people (eye roll) and is also very confident of his knowledge about my autoimmune disease. He believes in his own knowledge more than that of experts in their fields, and he will do whatever the President says to do. I haven't decided what I will do when that happens.
 
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CalGalTraveler

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Here is a series from a data scientist exploring whether the curve is flattening in the SF Bay Area. As you may know, the Bay Area was one of the first regions to adapt Shelter in Place across multiple counties. As you know NYC was enacted later with several adjacent states with NYC commuters enacting SIP only recently. Los Angeles also adopted later and has experienced a mushrooming of cases. Of course...early data, more testing but interesting data points no less.

https://swell.life/article/rMYhMFSUJ7LO/is-the-bayarea-curve-flattening (as of Mar 26)

1585322911463.png




1585322851796.png


Original Article Mar 24

 
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1Kflyerguy

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This article is few days old, but i think it offers a good explanation of why the cases exploded in Silicon Valley, my home town....


My team shifted to Work from Home on March 5th, that is well in advance of our corporate directive and then the government orders.
 

DaveNW

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The spikes in cases seems like a response to the length of time before symptoms tend to show up. The real test will be within the next few weeks after "everyone" has been staying home. I'd expect things to slow down, to a degree. But even if this reaches a peak of cases on a certain day and then declines, it still means the day after that peak there are still a lot of new cases, and a lot of new cases the day after that, and so on. Until the curve is totally flat, and there are no new cases, will we be closer to being beyond this. It's all going to take time.

Stay healthy!

Dave
 

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The spikes in cases seems like a response to the length of time before symptoms tend to show up. The real test will be within the next few weeks after "everyone" has been staying home. I'd expect things to slow down, to a degree. But even if this reaches a peak of cases on a certain day and then declines, it still means the day after that peak there are still a lot of new cases, and a lot of new cases the day after that, and so on. Until the curve is totally flat, and there are no new cases, will we be closer to being beyond this. It's all going to take time.

Stay healthy!

Dave
I think the spikes is caused by 2 things: 1. The incubation period of 14 to 21 days; and, 2. The increase in testing.
 
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