[FRIAM] Practical Covid Guidlines

Thu Jun 11 17:30:05 EDT 2020

Arizona and Texas increase in Covid-19 cases called spikes:

https://www.vox.com/2020/6/11/21286431/coronavirus-arizona-covid-19-cases-deaths-navajo-nation

https://www.kvue.com/article/news/health/coronavirus/austin-coronavirus-updates-cases-spike/269-5e7306b0-244e-481c-bf40-1f20e798bbed

On Thu, Jun 11, 2020 at 2:59 PM Marcus Daniels <marcus at snoutfarm.com> wrote:

> https://github.com/nytimes/covid-19-data
>
> https://www.nytimes.com/interactive/2020/us/arizona-coronavirus-cases.html
>
> https://www.nytimes.com/interactive/2020/us/arizona-coronavirus-cases.html
>
>
>
>
>
> *From: *Friam <friam-bounces at redfish.com> on behalf of Prof David West <
> profwest at fastmail.fm>
> *Reply-To: *The Friday Morning Applied Complexity Coffee Group <
> friam at redfish.com>
> *Date: *Thursday, June 11, 2020 at 1:53 PM
> *To: *"friam at redfish.com" <friam at redfish.com>
> *Subject: *Re: [FRIAM] Practical Covid Guidlines
>
>
>
> "spiking" according to ... ? Governor? Health department? Official or
> semi-official (or media) analyst? And how isolated is the spike?
>
>
>
> davew
>
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>
>
> On Thu, Jun 11, 2020, at 1:56 PM, Frank Wimberly wrote:
>
> Arizona and Texas are "spiking" as of today.  We're surrounded.
>
>
>
> ---
>
> Frank C. Wimberly
>
> 140 Calle Ojo Feliz,
>
> Santa Fe, NM 87505
>
>
>
> 505 670-9918
>
> Santa Fe, NM
>
>
>
> On Thu, Jun 11, 2020, 1:45 PM Prof David West <profwest at fastmail.fm>
> wrote:
>
>
>
> I was going to make a separate post this morning claiming that my June
> 15th prediction had been realized. The 'straw' was 19 Governor's of states
> with rising rates, stated that restrictions would continue to be lifted on
> schedule and the rise in rates could be handled. All said there would be no
> return to lock down.Utah is the only state that delayed, by two weeks and
> for the Salt Lake City area, complete lifting of restrictions. The word
> "spike" is seldom seen in headlines — replaced with "rise."
>
>
>
> Poker rooms are opening, even in CA, with 5-6 person tables instead of 9-10
>
>
>
> Travel is not mentioned in the missive Nick included because people are
> simply traveling. The highways in southern Utah and the parks is typical
> summer volume already. RV parks are full. Campgrounds are full. Greyhound
> and FlixBus are reopening.
>
>
>
> Carnival operators in Holland blocked a major highway today demanding, and
> evidently getting, permission to open for the summer traveling season.
> (talk about a vector!)
>
>
>
> davew
>
>
>
>
>
> On Thu, Jun 11, 2020, at 11:35 AM, thompnickson2 at gmail.com wrote:
>
> I wonder what The Congregation, including the Diaspora, thought about
> this. Nothing very dramatic, here, but that’s just the point.  Nothing on
> travel.
>
>
>
> From Dr. James Stein, Professor of Cardiovascular Research at the
> University of Wisconsin School of Medicine and Public Health…
>
>  COVID-19 update as we start to leave our cocoons. The purpose of this
> post is to provide a perspective on the intense but expected anxiety so
> many people are experiencing as they prepare to leave the shelter of their
> homes. My opinions are not those of my employers and are not meant to
> invalidate anyone else’s – they simply are my perspective on managing risk.
>
>  In March, we did not know much about COVID-19 other than the incredibly
> scary news reports from overrun hospitals in China, Italy, and other parts
> of Europe. The media was filled with scary pictures of chest CT scans,
> personal stories of people who decompensated quickly with shortness of
> breath, overwhelmed health care systems, and deaths. We heard confusing and
> widely varying estimates for risk of getting infected and of dying – some
> estimates were quite high.
>
> Key point #1: The COVID-19 we are facing now is the same disease it was 2
> months ago. The “shelter at home” orders were the right step from a public
> health standpoint to make sure we flattened the curve and didn’t overrun
> the health care system which would have led to excess preventable deaths.
> It also bought us time to learn about the disease’s dynamics, preventive
> measures, and best treatment strategies – and we did. For hospitalized
> patients, we have learned to avoid early intubation, to use prone
> ventilation, and that remdesivir probably reduces time to recovery. We have
> learned how to best use and preserve PPE. We also know that several
> therapies suggested early on probably don’t do much and may even cause harm
> (ie, azithromycin, chloroquine, hydroxychloroquine, lopinavir/ritonavir).
> But all of our social distancing did not change the disease. Take home: We
> flattened the curve and with it our economy and psyches, but the disease
> itself is still here.
>
> Key point #2: COVID-19 is more deadly than seasonal influenza (about 5-10x
> so), but not nearly as deadly as Ebola, Rabies, or Marburg Hemorrhagic
> Fever where 25-90% of people who get infected die. COVID-19’s case fatality
> rate is about 0.8-1.5% overall, but much higher if you are 60-69 years old
> (3-4%), 70-79 years old (7-9%), and especially so if you are over 80 years
> old (CFR 13-17%). It is much lower if you are under 50 years old (<0.6%).
> The infection fatality rate is about half of these numbers. Take home:
> COVID-19 is dangerous, but the vast majority of people who get it, survive
> it. About 15% of people get very ill and could stay ill for a long time. We
> are going to be dealing with it for a long time.
>
>  Key point #3: SARS-CoV-2 is very contagious, but not as contagious as
> Measles, Mumps, or even certain strains of pandemic Influenza. It is spread
> by respiratory droplets and aerosols, not food and incidental contact. Take
> home: social distancing, not touching our faces, and good hand hygiene are
> the key weapons to stop the spread. Masks could make a difference, too,
> especially in public places where people congregate. Incidental contact is
> not really an issue, nor is food.
>
>  What does this all mean as we return to work and public life? COVID-19 is
> not going away anytime soon. It may not go away for a year or two and may
> not be eradicated for many years, so we have to learn to live with it and
> do what we can to mitigate (reduce) risk. That means being willing to
> accept *some* level of risk to live our lives as we desire. I can’t decide
> that level of risk for you – only you can make that decision. There are few
> certainties in pandemic risk management other than that fact that some
> people will die, some people in low risk groups will die, and some people
> in high risk groups will survive. It’s about probability.
>
>  Here is some guidance – my point of view, not judging yours:
>
> 1. People over 60 years old are at higher risk of severe disease – people
> over 70 years old, even more so. They should be willing to tolerate less
> risk than people under 50 years old and should be extra careful. Some
> chronic diseases like heart disease and COPD increase risk, but it is not
> clear if other diseases like obesity, asthma, immune disorders, etc.
> increase risk appreciably. It looks like asthma and inflammatory bowel
> disease might not be as high risk as we thought, but we are not sure -
> their risks might be too small to pick up, or they might be associated with
> things that put them at higher risk.
>
> People over 60-70 years old probably should continue to be very vigilant
> about limiting exposures if they can. However, not seeing family –
> especially children and grandchildren – can take a serious emotional toll,
> so I encourage people to be creative and flexible. For example, in-person
> visits are not crazy – consider one, especially if you have been isolated
> and have no symptoms. They are especially safe in the early days after
> restrictions are lifted in places like Madison or parts of major cities
> where there is very little community transmission. Families can decide how
> much mingling they are comfortable with - if they want to hug and eat
> together, distance together with masks, or just stay apart and continue
> using video-conferencing and the telephone to stay in contact. If you
> choose to intermingle, remember to practice good hand hygiene, don’t share
> plates/forks/spoons/cups, don’t share towels, and don’t sleep together.
>
>  2. Social distancing, not touching your face, and washing/sanitizing your
> hands are the key prevention interventions. They are vastly more important
> than anything else you do. Wearing a fabric mask is a good idea in crowded
> public place like a grocery store or public transportation, but you
> absolutely must distance, practice good hand hygiene, and don’t touch your
> face. Wearing gloves is not helpful (the virus does not get in through the
> skin) and may increase your risk because you likely won’t washing or
> sanitize your hands when they are on, you will drop things, and touch your
> face.
>
>  3. Be a good citizen. If you think you might be sick, stay home. If you
> are going to cough or sneeze, turn away from people, block it, and sanitize
> your hands immediately after.
>
>  4. Use common sense. Dial down the anxiety. If you are out taking a walk
> and someone walks past you, that brief (near) contact is so low risk that
> it doesn’t make sense to get scared. Smile at them as they approach, turn
> your head away as they pass, move on. The smile will be more therapeutic
> than the passing is dangerous. Similarly, if someone bumps into you at the
> grocery store or reaches past you for a loaf of bread, don’t stress - it is
> a very low risk encounter, also - as long as they didn’t cough or sneeze in
> your face (one reason we wear cloth masks in public!).
>
> 5. Use common sense, part II. Dial down the obsessiveness. There really is
> no reason to go crazy sanitizing items that come into your house from
> outside, like groceries and packages. For it to be a risk, the delivery
> person would need to be infectious, cough or sneeze some droplets on your
> package, you touch the droplet, then touch your face, and then it invades
> your respiratory epithelium. There would need to be enough viral load and
> the virions would need to survive long enough for you to get infected. It
> could happen, but it’s pretty unlikely. If you want to have a staging
> station for 1-2 days before you put things away, sure, no problem. You also
> can simply wipe things off before they come in to your house - that is fine
> is fine too. For an isolated family, it makes no sense to obsessively wipe
> down every surface every day (or several times a day). Door knobs, toilet
> handles, commonly trafficked light switches could get a wipe off each day,
> but it takes a lot of time and emotional energy to do all those things and
> they have marginal benefits. We don’t need to create a sterile operating
> room-like living space. Compared to keeping your hands out of your mouth,
> good hand hygiene, and cleaning food before serving it, these behaviors
> might be more maladaptive than protective.
>
> 6. There are few absolutes, so please get comfortable accepting some
> calculated risks, otherwise you might be isolating yourself for a really,
> really long time. Figure out how you can be in public and interact with
> people without fear.
>
>
>
>      *Error! Filename not specified.*
>
> Steven W. Tabak, M.D., F.A.C.C.   |   Medical Director, Quality and
> Physician Outreach
>
>
> ____________________________________________________________________________________________________________________________________________________________________________
>
>
>
>
>
> Nicholas Thompson
>
> Emeritus Professor of Ethology and Psychology
>
> Clark University
>
> ThompNickSon2 at gmail.com
>
> https://wordpress.clarku.edu/nthompson/
>
>
>
>
>
>
>
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-- 
Frank Wimberly
140 Calle Ojo Feliz
Santa Fe, NM 87505
505 670-9918
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