Monday, July 13, 2020

A Framework for Coronavirus Policy

There are two general ways to reduce the transmission of the virus.  One is “engineering”, changing the physical environment, the other is “social”, changing behavior to keep people distant from each other.  Under engineering we can include not only physical partitions, UV lighting and ventilation, but also mask-wearing and other PPE.  I know, there is a very large behavioral component to masking, but I want to focus on the distancing aspect, so let’s put everything else in the engineering box.

Now for distancing.  Suppose we know instantaneously and with certainty everyone who is infected.  In that case we can selectively quarantine them, and this will cut off transmission.  That is possible only in rare circumstances, such as a country that has fully eradicated the virus but has occasional external visitors.  If you have a reliable test you can identify anyone arriving with the disease and isolate them.  The rest of the population, known to be uninfected and unexposed, can move freely and congregate as they want.

A more realistic case is that you know with near certainty everyone who is infected, but only with a delay.  Then those who came into contact with them during their potential spreading period are also suspect and need to be isolated.  This is the idea behind contact tracing, which imposes distancing on a small subset of the population who may not be infected but leaves everyone else free to go on with their life.

Now what happens if there is some combination of too many cases, too little or inaccurate testing, and insufficient tracing?  This is where we are now, and the only recourse if we want to get control over the pandemic is to impose distancing on the entire population or as much of it as possible.  Only after this policy reduces the number of active cases to the point where testing and tracing can bring us back to the previous state will it be advisable to resume most congregating activity.

What it all adds up to is the notion that distancing is distancing, whether it applies only to quarantining those already infected, the larger group who have been in contact with those infected, or the whole population.  The smaller the number of people to whom distancing can be applied, the better.  The goal of policy should be to systematically move from the third case to the second and then to the first.


Anonymous said...

July 13, 2020

‘We’re Not an Island’: Rural Outbreaks Challenge Oregon’s Virus Success
Oregon was sandwiched between two states that had big coronavirus outbreaks but managed to keep its numbers low. Until it couldn’t.
By Kate Conger

Anonymous said...

July 13, 2020



Cases   ( 3,454,259)
Deaths   ( 138,020)

Anonymous said...

July 13, 2020



Cases   ( 3,454,259)
Deaths   ( 138,020)


Cases   ( 906,617)
Deaths   ( 23,727)


Cases   ( 299,750)
Deaths   ( 35,006)


Cases   ( 290,133)
Deaths   ( 44,830)


Cases   ( 200,378)
Deaths   ( 9,137)


Cases   ( 107,807)
Deaths   ( 8,787)


Cases   ( 83,602)
Deaths   ( 4,634)


Cases   ( 75,826)
Deaths   ( 5,536)

ilsm said...


NYC, some would propose 'the virus burned out' less controversial than claiming 'herd immunity', community transmission is very small, it has the same problem as Oregon, new cases are travel (airports, rail, interstates) related and from the hospitals with ongoing Covid 19 census.

With luck Oregon and NYC's 'death' curve will stay flat.......

Nothing much matters until we deploy highly effective treatments and the vaccine(s) that works.

Fred C. Dobbs said...

WHO warns that coronavirus crisis may get 'worse and worse and worse'

GENEVA/ZURICH (Reuters) - The new coronavirus pandemic raging around the globe will worsen if countries fail to adhere to strict healthcare precautions, the World Health Organization (WHO) warned on Monday.

“Let me be blunt, too many countries are headed in the wrong direction, the virus remains public enemy number one,” WHO Director General Tedros Adhanom Ghebreyesus told a virtual briefing from the U.N. agency’s headquarters in Geneva.

“If basics are not followed, the only way this pandemic is going to go - it is going to get worse and worse and worse.”

Global infections stand at 13 million, according to a Reuters tally, with more than half a million deaths. ... said...

The most important thing in combating the virus in the US may have happened on Saturday: Trump wore a mask in public to Walter Reed Hospital. The irony is that what may do more to get him reelected had to be pushed onto him not on the basis of saving lives but that apparently his aides convinced him he looks good in this mask. Really.

Anonymous said...

July 13, 2020



Cases   ( 3,464,772)
Deaths   ( 138,095)

Anonymous said...

July 13, 2020

California Imposing Sweeping Rollback of Reopening Plans Amid Case Surges

Fred C. Dobbs said...

(In case you missed it.)

Trump wears mask in public for first time during pandemic

<a href=">Looks angry</a>

via @BostonDotCom

Fred C. Dobbs said...

Looks angry

Anonymous said...

July 13, 2020



Cases   ( 3,473,145)
Deaths   ( 138,162)

Anonymous said...

July 13, 2020

America Drank Away Its Children’s Future
As the school year looms, the pandemic is still raging.
By Paul Krugman

A brief history of the past four months in America:

Experts: Don’t rush to reopen, this isn’t over.

Donald Trump: LIBERATE!

Covid-19: Wheee!

Trump officials: Here’s our opposition research on Anthony Fauci.

And we’re now faced with an agonizing choice: Do we reopen schools, creating risks of a further viral explosion, or do we keep children home, with severe negative effects on their learning?

None of this had to happen....

Anonymous said...

There is a decisive spreading of the coronavirus in the southern hemisphere now, the wintering hemisphere.  This is a further sign of how careful we should be in encouraging school openings in fall.  After all, we are in the midst of the initial outbreak and we so far have shown no collectively necessary discipline in protecting against infection.

Could we properly protect students and teachers?  Where is the evidence; where is the model; where are the precise plans?

Anonymous said...

There are of course states in which grade schools open in August. Colleges often open in August. However, I am thinking of fall and a way to safely open then is as yet completely unclear.

Anonymous said...

Your reference to the third case, second, first reminded me of the Who's on First baseball comedy routine by Abbott and Costello - in some way, it represents some of the miscommunications that have occurred in the way the current administration has been engaging in doublespeak about the virus and the 'great' job they are doing.

Abbott: Who is on first.
Costello: What are you askin' me for? I'm askin' you, who's on first?
Abbott: That's it.
Costello: Well go ahead and tell me.
Abbott: Who.
Costello: The guy on first.
Abbott: That's it.
Costello: What's the guy's name on first?
Abbott: No, What's on second.
Costello: I'm not askin' you who's on second!
Abbott: Who's on first.
Costello: That's what I'm askin' you! Who's on first?
Abbott: Now wait a minute. Don't...don't change the players.
Costello: I'm not changin' nobody! I asked you a simple question. What's the guys' name on first base?
Abbott: What's the guy's name on second base.
Costello: I'm not askin' you who's on second!
Abbott: Who's on first.
Costello: I don't know.
Abbott: He's on third. Now we're not talking about him.
Costello: Look, you got a first baseman?
Abbott: Yes.
Costello: Then tell me the fella's name playin' first.
Abbott: Who.
Costello: The guy playin' first.
Abbott: That's his name.
Costello: Wait...What's the guy's name on first base?
Abbott: What is the guy's name on second base!
Costello: Who's playin' second?
Abbott: Who's playin' first.
Costello: I don't know.
Abbott: He's on third base.
Costello: Look, when you pay off the first baseman every month, who do you pay the money to?
Abbott: Every dollar of it.
Costello: Yeah. Look, you gotta pay the money to somebody on first base, don't you?
Abbott: Yeah.
Costello: Does he give you a receipt?
Abbott: Sure.
Costello: How does he sign the receipt?
Abbott: Who.
Costello: The guy that you give the money to.
Abbott: Who.
Costello: The guy you give the money to.
Abbott: That's how he signs it.
Costello: That's how who signs it?
Abbott: Yes.
Costello: Well go ahead and tell me!? Abbott: That's it.
Costello: That's who?
Abbott: Yeah.
Costello: When you give the guy the money, doesn't he have to sign the receipt?
Abbott: He does!
Costello: Well how does he sign his name?
Abbott: Who.
Costello: The guy you give the money to.
Abbott: That's how he signs it!
Costello: You! You...You just don't give money to someone without having 'em sign the receipt!
Abbott: No! Who signs it.
Costello: What are you askin' me for?
Abbott: Now calm down. I'm not asking you, I am telling you. The...
Costello: Well go ahead and tell me. What's the guy's name that signs the receipt on first base?
Abbott: Well now wait a minute. What signs his own receipt.
Costello: Who signs his own receipt?
Abbott: No, Who signs his.
Costello: I'm askin' you, when the guy on first base gives you a piece of paper...
Abbott: Yes, now wait...
Costello: ...he puts his name on it.
Abbott: No, Who puts his name on it...
Costello: How...
Abbott: ...and what puts his name on it...
Costello: How does the fella's name on first base look to you when he signs his name?
Abbott: Who.
Costello: To you.
Abbott: That's how it does.

Anonymous said...

Apparently, it is more important to look good, then to feel good - Fernando Lamas, played by Billy Crystal on SNL. Trump you look Mahvelous in your mask!

Kaleberg said...

The plan sounds good, and it may be all we have for a while. We've had a number of problems in just getting people accept that COVID-19 is a problem, and that's ignoring the political problems.

One is that exponential growth doesn't behave in accord with most people's intuition: one case on Monday, two on Tuesday, four on Wednesday, what's the big deal?

The other is that the US is large and not tightly interconnected so the disease passes through different nodes at different times. That means we get infections in big cities, then infections that spread from mid-sized cities and then smaller and smaller nodes. Each wave is easy to dismiss until it isn't, and the lag is often mistaken for a lucky miss.

Fred C. Dobbs said...

NY Confronts Second-Wave Risk: Visitors From Florida and Texas

NY Times - July 14

New York, once the center of the coronavirus pandemic, has so successfully stemmed the outbreak that its death and hospitalization rates have plummeted and it has among the lowest infection rates in the country.

But the state and its neighbors are facing a disquieting new threat: Can they keep the virus suppressed when it is raging across the South and West?

Officials and public health experts are especially concerned that infected travelers from any of the nearly 40 states where the outbreak is spiking could set off new clusters in New York. Gov. Andrew M. Cuomo on Monday imposed more restrictions on travelers from states with high infection rates, but it is not all clear that they will be followed — or are even enforceable.

Tens of thousands of people enter New York daily through its airports, highways and train stations, and compliance largely depends on the whims of visitors and of residents returning home.

Mr. Cuomo has warned it is almost inevitable that the virus will seep back into the state, much the way it came to New York through flights from Europe in February. He has also raised concerns that some New Yorkers might let their guard down and blamed local governments for not enforcing mask-wearing and social-distancing measures. ...

Fred C. Dobbs said...

Cuomo orders travelers to provide contact info when entering NY from high-infection states

via @Newsday

Travelers from states with high infection levels of COVID-19 — such as Florida and Texas — will be required to provide contact information before they leave the airport or face a $2,000 fine, Gov. Andrew M. Cuomo announced Monday.

The emergency health order, issued by the state Department of Health, mandates travelers from those states must provide a location form before they leave the airport, Cuomo said.

“You must give officials at the airport your form as to where you came from and where you are going before you leave the airport,” Cuomo said during a news conference in Manhattan. “It will be enforced in every airport in the State of New York.” ...

Fred C. Dobbs said...

Moderna’s COVID-19 vaccine poised for final testing

via @BostonGlobe - July 14

A COVID-19 vaccine developed by Cambridge-based Moderna in a collaboration with the National Institutes of Health spurred immune responses in healthy patients who received it, although it caused mild side effects in many of them, according to the first published data about the small, early-stage clinical trial.

The vaccine, which was the first of at least 21 to enter clinical trials, produced antibodies in all 45 patients who began receiving two shots 28 days apart in March, said the study (*) in the New England Journal of Medicine. Three groups of 15 volunteers received varying dosages. ...

“No matter how you slice this, this is good news,” Dr. Anthony Fauci, the US government’s leading infectious disease specialist, told the Associated Press.

Moderna, whose stock is up more than 200 percent this year as the firm has blitzed the media and fueled expectations, had drawn criticism for failing to share backup data. That’s what the journal published Tuesday.

It showed that after volunteers received a second shot, neutralizing antibodies were detected in all the participants who were evaluated, at levels far exceeding those in 38 patients with confirmed diagnoses of COVID-19.

The authors of the study, however, noted that they were unable to say how long that immune response lasted, a crucial question when weighing the effectiveness of a vaccine. The participants will be monitored for a year after they received their second shot to see if they remain immune.

Unlike traditional vaccines, which use a weakened or killed virus to stimulate an immune response, Moderna’s vaccine relies on genetic material called messenger RNA, or mRNA. The vaccine inserts portions of the coronavirus’s RNA into cells, which then manufacture a piece of the virus to generate antibodies. ...

The project has received $483 million from the federal Biomedical Advanced Research and Development Authority. It is one of at least four potential COVID-19 vaccines that have the backing of Operation Warp Speed, a federal government initiative to speed up the development of countermeasures against the virus.

Moderna on Tuesday posted details of its final-stage vaccine trial on an official government website, confirming that the widely anticipated trial was still on track to begin this month. Moderna said the trial is expected to begin on July 27 and will will enroll 30,000 adults at high risk of contracting the coronavirus.

Trial sites will begin registering people for the trial next week, said a Moderna spokesman.

* An mRNA Vaccine against SARS-CoV-2 — Preliminary Report

ilsm said...

I was going to write about 'virus burning out' in NYC despite NYT's contentions but.....

Here is page to volunteer for Covid 19 Ph III vaccine and anti body trials.

Scroll down and hit Volunteer Button.

Being as Moderna is near Boston and older people need to participate......

Fred C. Dobbs said...

Interested in volunteering for a COVID-19 Prevention Clinical Study?

Fred C. Dobbs said...

Politics endanger COVID-19 vaccine

via @BostonGlobe - editorial - July 14

... for Americans to benefit from a vaccine, it won’t be enough for one to be discovered and proven to work. To return to daily life as it was before the pandemic while protecting public health, a vaccine must be broadly available, and people will need to actually take it. At present, the US president is threatening both those crucial ingredients for success.

Scientists in the United States and China are in a race to develop a COVID-19 vaccine, with at least nine contenders being evaluated by various groups. There’s no telling which group, in which country, will develop the best vaccine first, and which country or countries will be poised to produce that vaccine quickly at scale for large populations. While global health crises are typically an opportunity for diplomacy — for example, the United States and Russia coordinated polio and smallpox vaccination during the Cold War, and the US sent military aid to West Africa in 2014 to respond to Ebola — Trump has taken a nationalistic approach to the coronavirus. ...

Meanwhile, the White House has withdrawn the US from the World Health Organization, where critical conversations happen that abet collaboration across borders on vaccines and pandemic response.

It’s no small danger that a COVID-19 vaccine could become a political pawn rather than a shared humanitarian tool. Regardless of which country wins the race, such nationalism would be detrimental to Americans — whether it means delayed access to the vaccine for us or an ongoing breeding ground abroad for a virus that will not obey border controls.

Public trust in the vaccine will also be critical; if many people are afraid to take it, it will not confer adequate protection to the population to allow daily life and business to fully resume. In an era when anti-vaccine movements have been on the rise in the United States, this is a looming threat. Here the president has been equally unhelpful. He has cast a pall of distrust over scientific agencies’ response to the virus by touting, and urging the Food and Drug Administration to authorize, an unproven and probably harmful COVID-19 cure, hydroxychloroquine, and by asking the Centers for Disease Control and Prevention to change its public health guidelines on reopening schools. While the typical time line for a vaccine is being sped up, mostly due to paperwork and regulatory hurdles being cleared, the president is pressuring officials to move even faster, in a way that implies to some observers that corners could be cut when it comes to patient safety. (The scientists and companies working on vaccines in the United States deny that such corner-cutting is actually happening now, though several are exploring methods to expedite testing, including “challenge trials,” in which healthy volunteers are infected with the virus to more quickly test vaccines’ safety and effectiveness.)

The problem is one of perception: Even if the vaccine ultimately introduced to the public is as safe as any other medical intervention of recent decades and much safer than not taking it, the public must be willing to trust that. Yet this White House has time and again in recent months undermined scientific integrity, while the president and vice president spout scientific misinformation. While polls show the majority of Americans (especially Democrats) trust the CDC and Dr. Anthony Fauci, a member of the White House coronavirus task force and director of the National Institute of Allergy and Infectious Diseases, the recent sidelining of Fauci by the White House raises the question of whether scientists who stick to the facts will be the ones to deliver public health messages about a vaccine to the American people, or whether the president will take it upon himself. If it’s the latter, Americans have much to fear. ...

Fred C. Dobbs said...

CDC chief says Northerners heading South for vacation may be to blame

for surge in coronavirus cases, not state reopenings

... The current surge in coronavirus cases across the American South may have been caused by Northerners who traveled South for vacation around Memorial Day, said Dr. Robert Redfield, director of the Centers for Disease Control and Prevention.

“If you look at the South, everything happened around June 12 to June 16. It all simultaneously kind of popped,” he said in an interview Tuesday with Dr. Howard Bauchner of The Journal of the American Medical Association. Independent of state reopening plans, “we’re of the view that there was something else that was the driver. Maybe the Memorial Day, not weekend, but the Memorial Day week, where a lot of Northerners decided to go South for vacations.” ...

Fred C. Dobbs said...

White House distances itself from Trump aide’s op-ed slamming Anthony Fauci

via @BostonGlobe - July 15

The White House is working to distance itself from a USA Today op-ed written by trade adviser Peter Navarro that called Anthony Fauci, the nation’s highest-ranking infectious disease expert, “wrong about everything I have interacted with him on.”

In the short op-ed published on Tuesday, Navarro used a series of out-of-context quotes from Fauci to cast himself and the Trump administration as early to act on the coronavirus threat while being hamstrung by a hesitant Fauci.

“Dr. Anthony Fauci has a good bedside manner with the public, but he has been wrong about everything I have interacted with him on,” Navarro wrote.

In one example, Navarro wrote that Fauci had dismissed the coronavirus threat in mid-February as “low risk,” but left out the rest of his comment.

“The risk right now, today, currently, is really relatively low for the American public. But that could change because [of] what’s going on outside the United States,” Fauci said in an interview with USA Today. “This could evolve into a global pandemic which would then have significant implications for us.” ...

Fred C. Dobbs said...

Graphic: US shows little signs of being able to control coronavirus spread
The coronavirus outbreak in the United States continues to worsen. More than 30 states in the country are now showing signs of decline, while only four are showing signs of positively curbing the virus, according to Covid Exit Strategy.

Boston Globe - July 15

Graphic: US unable to control coronavirus spread

Fred C. Dobbs said...

Fauci appears to have a new role: Scapegoat

Washington Post via @MSN

... Fox News polling over the past four months has found a slight erosion in how well Americans think the federal government is handling the pandemic. In March, 56 percent of Americans viewed the federal government’s response with approval, a figure that slid to 50 percent by June. Among Republicans, the drop was similar, from 80 percent to 73 percent. More worrisome for Trump, though, was the plunge in the number that viewed the federal response with strong approval. In March, 41 percent of Republicans held strongly approving views of how the feds were doing. In June, only 25 percent did.

... Donald Trump, who is up for reelection in November and who is in dire need of strong support from Republicans to win that contest. It’s useful, then, for Trump to have someone who can absorb the flak directed from his own party at his government. And for that, Fauci is perfect.

Republicans may not have needed much of a push in that direction. Fox’s polling shows that, while views of Fauci among Democrats have improved slightly, views of the doctor among Republicans have plunged faster than views of the federal government’s response. ...

Fred C. Dobbs said...

Lower working memory capacity linked to non-compliance with social distancing guidelines

during the early stage of the coronavirus outbreak

PsyPost - July 11

New research provides preliminary evidence that working memory is associated with engaging in social distancing in the early stages of the coronavirus pandemic. The new study has been published in the Proceedings of the National Academy of Sciences.

On March 11th, 2020, the World Health Organization declared the outbreak of the novel coronavirus SARS‐CoV‐2 to be a global pandemic. Governments around the world urged people to follow preventive health measures such as frequent hand washing and physical distancing. But not everyone abided by the safety guidelines.

“At the moment, successful containment of the COVID-19 outbreak critically relies on people’s voluntary compliance with social distancing guidelines. However, there is widespread non-compliance in our society, especially during the early stage of this pandemic (and more recently after reopening),” said study author Weizhen Xie (Zane), a postdoctoral research fellow at the National Institute of Neurological Disorders and Stroke.

The researcher noted that there have been numerous media reports about Americans failing to physically distance themselves from one another in public spaces.

“As a researcher in cognitive psychology, I feel that it is our duty to figure out why some people follow the developing norm of social distancing while others ignore it. Addressing this issue may help mitigate the current public health crisis due to the COVID-19,” Xie said.

In two studies, the researchers surveyed 850 U.S. residents between March 13 and March 25, 2020 — the first two weeks following the U.S. presidential declaration of a national emergency about the COVID-19 pandemic. In addition to collecting demographic information and assessing social distancing compliance, the surveys included assessments of working memory, personality, mood, and fluid intelligence. ...

Fred C. Dobbs said...


What Does 'Covidiot' Mean, and Who Qualifies as One?


Fred C. Dobbs said...

How to fix the raging Covid-19 dumpster fire in the US

via @statnews - July 14

(Some suggestions at the link.)

There’s no point in sugar-coating this. The U.S. response to the Covid-19 pandemic is a raging dumpster fire.

Where a number of countries in Asia and Europe have managed to dampen spread of the SARS-CoV-2 virus to the point where they can consider returning to a semblance of normalcy — friends from Paris just emailed me pictures from their Sicilian vacation — many international borders remain closed to Americans.

On Sunday, Florida reported more than 15,000 cases — in a single day. South Korea hasn’t registered 15,000 cases in the entire pandemic to date. One day last week the U.S. recorded more than 68,000 cases.

The website has updated its previously tri-colored U.S. map, which showed states as either green, signifying they are trending better; yellow, making progress; or red, trending poorly. A fourth designation, called “bruised red,” signals states with uncontrolled spread; criteria for this category includes hospitals nearing capacity both in terms of overall beds and ICU space. Already 17 states are wearing bruised red. ...

Fred C. Dobbs said...

Anthony Fauci rebukes Trump administration’s efforts to discredit him

‘It’s nonsense’

via @BostonGlobe - July 15

Anthony Fauci on Wednesday sharply criticized the Trump administration’s efforts to discredit him, delivering an unusual rebuke to the administration and urging top officials to focus on the pandemic.

In an interview with The Atlantic magazine, Fauci pushed back on the recent claims made by anonymous White House staffers that he was wrong during the early stages of the crisis.

“It’s nonsense. It’s completely wrong. The whole thing is wrong. The whole thing is incorrect,” he said.

He also said he told White House chief of staff Mark Meadows during a recent meeting that attacks on him ultimately hurt the president.

“I cannot figure out in my wildest dreams why they would want to do that. I think they realize now that that was not a prudent thing to do, because it’s only reflecting negatively on them,” Fauci told the Atlantic in a series of interviews published on Wednesday. ...

Fred C. Dobbs said...

US announces a nearly $2 billion contract for 600 million doses of a coronavirus vaccine

NY Times - July 22

The Trump administration on Wednesday announced a nearly $2 billion contract with the pharmaceutical giant Pfizer and a smaller German biotechnology company for up to 600 million doses of a Covid-19 vaccine, with the companies on track to manufacture the first 100 million doses by December.

Under the arrangement, the federal government would obtain the first 100 million doses for $1.95 billion, with the rights to acquire up to 500 million more. Americans would receive the vaccine for free. Before it could be distributed, it would first need at least emergency approval by the Food and Drug Administration.

Large-scale safety trials are to begin this month, with regulatory review set for as early as October.

“Depending on success in clinical trials, today’s agreement will enable the delivery of approximately 100 million doses of vaccine being developed by Pfizer and BioNTech,” Alex M. Azar II, the health secretary, said in a statement announcing the deal.

The agreement, which the Department of Health and Human Services announced Wednesday morning, is the largest contract yet for “Operation Warp Speed,” the government’s crash coronavirus vaccine program. The federal government announced earlier this month that it would pay the Maryland-based company Novavax $1.6 billion to expedite the development of a coronavirus vaccine. ...