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D&D and the rising pandemic


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Zardnaar

Legend
(shrugs)
Without digging further & then worrying about things I can't really control I couldn't tell you.
Supposedly here in Ohio we were/are doing quite well. I presume that this is due in part to 1) being one of the states that did a good job of shutting things down fairly early & fairly completely (we're no NZ, but vs the rest of the USA....), 2) spinning the data in whatever ways seems most advantageous. They have said that state-wise testing is not where they'd like it to be.

I do think that our re-opening plan was a bit soon , a bit haphazard, & with vague wordings.
For example: They opened things up before figuring out important details concerning things like day care. Strikes me that if you're going to send everyone back to work you should have a plan for what they're supposed to do with their kids 1st.....
And then there's the idiocy of getting a haircut. One week, early in the opening, hospitals were allowed to start preforming elective surgeries again. When the Governor was asked about things like Barbershops the reply was that they were still looking at how to do that safely. :/ Yes, you could go get cut open in a facility where your Covid odds are guaranteed to be dramatically higher - even if we really are doing better than others - for non-essential reasons. But you couldn't get a haircut.
Everyones like; The answers you wrap your barber in mask/gloves/gown/constant cleaning & hand washing/limit # of people in the shop at any given time, etc, wear a mask yourself, & touch as few surfaces as possible....
Several weeks later? Guess what the official answer was?

And here we are in early June & we have assorted groups starting to sue over the various re-opening details.
Yeah I've got a friend in Ohio. The governor was getting positive press not to long ago. Made the news here via the BBC.
 


ad_hoc

Hero
The 7 day rolling average of new cases in Massachusetts looks like this:

View attachment 122657
(graph from public radio station WBUR)
That is promising.

According to this site there are still 18 000 active cases which is a lot I think for the population.

 


Umbran

Mod Squad
Staff member
According to this site there are still 18 000 active cases which is a lot I think for the population.
The question is how they determine the number of "active" cases. The page you gave lists a dashboard I'm familiar with as the basis for its numbers, but that dashboard does not give "active cases" - that's not a number the state tracks, because it is not well-defined. So, your website is deriving that result, and I'd need to know how to comment.

As of two days ago, we had 1,415 cases in hospitals.

Massachusetts has a population of 6.9 million people.
 

Istbor

Dances with Gnolls
I have a concern.

While the number of new cases each day in the US seems to be slightly going down (some days spiking back up), it is mostly pretty consistent. ~20k a day.
The number of deaths though seems to be dropping much more dramatically.

Does this mean we have a handle on it, and enough space in hospitals to adequately care for our serious cases? Or perhaps we are in for a rise in deaths as well, but haven't hit that time threshold. OR! Even darker are we running low on at-risk people. I don't think the last one, that is just obligatory hyperbole. I would expect we would have had much more death if that were the case.

I suppose I don't know for sure how to feel. Positive that we are finding our stride in this, or worry that things will take a downturn, or worse, that data is being deliberately manipulated to show that re-opening is the correct choice and is working.

Apologies, but I can be a bit of a negative Nancy about certain things.
 

NotAYakk

Legend
Isbor, deaths lag infections by about 2 weeks, give or take.

Right now, the "heavy hit" areas pulled off successful distancing (like NYC). Their numbers are falling. The "less heavy hit" are making up for it, and have relatively explosive growth; but because we are adding, BIG NUMBER shrinking plus SMALL NUMBER exploding = BIG NUMBER shrinking slowly.

In the hard hit areas, the most vulnerable and exposed got burnt. The remaining vulnerable are hiding, because they where selected for hiding. Meanwhile, less serious cases who hid from ERs are getting tested, reducing the rate at which their numbers have fallen.

The future problem lies in either reignition of a hard hit area (NYC is about 25% infected, so it can repeat what happened before if you reopen), or more likely that areas that haven't been hard hit and haven't eliminated the virus continue to have numbers explode.

With deaths lagging infections by 2-3 weeks, and diagnosis lagging infection by a week, deaths are a 3+ week trailing indicator of things getting bad. And you have to pay attention to regional deaths, not national; national deaths are dominated by the areas the virus has done a burn-through wave of. The next areas likely to burn are ticking up from 1 death per week, to 1 death per day, to 2 deaths per day. With no effective distancing, and a 3 week lag, if an area has a doubling time of 3 days, that is 7 doublings "baked in"; there could already be enough people infected to be killing 100+ per day even if lockdown was perfect today.

OTOH, if their modest social distancing spreads doubling to 5 days, that is only 4 doublings, or 16x "baked in". A large swing, and leaves time for policy to change if there is an explosion of cases starting.

NYC burned brightly because it had a crazy spread rate of 2x every 2 days or something. By the time they hit 1 death/day, there where 10 doublings "backed in" (21/2 = 10.5), or a 1000-fold increase in deaths.

Background caution and spread out population gives time for a response to an exploding local epidemic. And it doesn't have to be perfect for this to be useful -- even if your measures result in Re over 1, so long as an epidemic doesn't sleep its way to 1000s of dead per day, you can choke it off.

Now, what happens if Re floats just above 1? You get a constant simmer and burn of dead people, but no spikes.
 

Umbran

Mod Squad
Staff member
I have a concern.

While the number of new cases each day in the US seems to be slightly going down (some days spiking back up), it is mostly pretty consistent. ~20k a day.
The number of deaths though seems to be dropping much more dramatically.

Does this mean we have a handle on it, and enough space in hospitals to adequately care for our serious cases?
It can be hard to say - looking at the overall number in such a large country as the US can be misleading. An overall trend could be level, while it is rising in one place while dropping in another. Boston, for example, has a stead decline in its number of cases per day. Meanwhile, Texas and Florida are trending up.

As others have said - deaths lag behind detected cases. SO, those areas of rising cases are apt to see deaths also rise in the not-too-distant future.

I suppose I don't know for sure how to feel.
I'd be surprised if you were sure how to feel. It is a still-developing situation.
 

There are definitely areas of the country where cases are falling, but there are also places where they're raising steadily. In my home county, we're still increasing by around 200 cases every day, and we've been on lockdown for more than 3 months now.
 

ad_hoc

Hero
Right now it looks like California, Texas, and Florida have the highest growth rates.

California has never hit a peak, it's just growing and up to 2700/day on average right now. The same is true of Texas, steady growth.

Florida spiked early and then had a sharp decline in cases/day. They have ramped back up though and are now at their previous peak and set to go past it.
 

NotAYakk

Legend
Ontario is down to 240 cases/day, and 90% of them are in one city (Toronto) and 75% of them are medical care (old folks homes included) related.

So 24 cases/day for 8 million (give or take) people (depending on how widely you define "Toronto"). Plus others asymptomatic, of course.

Good news:

Areas with exhaustive contact tracing are finding asymptomatic infected people (people who catch C19 and get better without symptoms), and more importantly, are not finding infections in turn from them. Presymptomatic people (people who have C19, and before they develop symptoms) are a different story.

So contract tracing based on people with symptoms and positive tests (even a runny nose) should be effective at making Re plummit; have their contacts isolate and get tested. (By going after their as-yet asymptomatic contacts, we catch presymotomatic people before they start infecting others).

Social distancing and the rise of summer means that traditional colds are dying off; so everyone with any cold-type symptoms gets tested, you have a good chance of being able to choke this thing off.

Add in modest social distancing (no indoor choir singing! Masks for service workers! Working from home when possible!) and ramp up the economy without megadeath. Maybe.

---

This is one of the reasons behind "flatten the curve". It bought time. We know more about how it spreads, we have more PPE, we have hospitals that know how to treat it, we have tests to detect it. Now we can drop Re more efficiently than we could in March.

And if we keep Re under 1.0 and this thing dies out.

Now, the number of additional infected during the die out phase is (1/(1-Re)). So an Re of 0.9 isn't that useful (as we get 10x more infected before it dies out). An Re of 0.5 means we get 2x more infected, and one of 0.25 means we get 33% more infected. OTOH, our learning and testing and contact tracing gets better as numbers fall and time passes; so even an Re of 0.9 means it doesn't get worse (per day), and if costs are low enough we can sustain that and start applying improved measures.
 

Theo R Cwithin

I cast "Baconstorm!"
Out of curiosity, does anyone know if is there's a difference between a "presymptomatic" and an "asymptomatic" case before a person gets sick/better; or is that something that can't be determined until after the case resolves?
 

MoonSong

Rules-lawyering drama queen but not a munchkin
Out of curiosity, does anyone know if is there's a difference between a "presymptomatic" and an "asymptomatic" case before a person gets sick/better; or is that something that can't be determined until after the case resolves?
I'm not sure... I'm going to ask the one health expert in my life later. Maybe it is that a pre-symptomatic person will show some signs in their body that show the disease is developping while the asymptomatic will be otherwise in perfect health just happens to be contagious?
 

Dannyalcatraz

Schmoderator
Staff member
I'm not sure... I'm going to ask the one health expert in my life later. Maybe it is that a pre-symptomatic person will show some signs in their body that show the disease is developping while the asymptomatic will be otherwise in perfect health just happens to be contagious?
Pretty much, though some researchers are now suggesting the asymptomatic may be almost non-contagious, and “asymptomatic spread” may in fact be “presymptomatic spread,”

I’m dubious of this in the light of the US Navy’s issues with the virus, but THEY had the complicating factor of tight, enclosed living/working space meaning even the mildly contagious had a greater chance of infecting others.
 

Istbor

Dances with Gnolls
It can be hard to say - looking at the overall number in such a large country as the US can be misleading. An overall trend could be level, while it is rising in one place while dropping in another. Boston, for example, has a stead decline in its number of cases per day. Meanwhile, Texas and Florida are trending up.

As others have said - deaths lag behind detected cases. SO, those areas of rising cases are apt to see deaths also rise in the not-too-distant future.



I'd be surprised if you were sure how to feel. It is a still-developing situation.
Fair. I understand the several week lag time, but maybe let my more recent thoughts override that reality check. Worry that this slow burn we are at could become a flare once again if we grew too complacent.

I did have my first chance at eating at a restaurant since early this year. Ate outside with ample space from any other groups. There were still some, mostly older folk who had masks for before and after consuming their food. Good that people are still being cautious.

I believe my county is set to possibly move to phase 2 near the 12th. Much of the rest of the state reopened without much of a plan.
 

Umbran

Mod Squad
Staff member
Out of curiosity, does anyone know if is there's a difference between a "presymptomatic" and an "asymptomatic" case before a person gets sick/better; or is that something that can't be determined until after the case resolves?
In terms of being able to know if you are one or the other? No. To casual observation, they are indistinguishable.

Which, of course, is a problem when you are trying to get people to do the right thing.
 

Zardnaar

Legend
There are definitely areas of the country where cases are falling, but there are also places where they're raising steadily. In my home county, we're still increasing by around 200 cases every day, and we've been on lockdown for more than 3 months now.
American lockdown is very lax. It will reduce the spread but won't choke it off.

Read yesterday another meat plant in Utah had around 25% of the staff infected.

We spent almost 5 weeks in level 4 lockdown. They closed almost everything. First week it was everything including online stuff. Supermarkets and pharmacy were open along with corner stores as they were essential. Supermarkets operated on one in one out and controlled foot traffic.

Then we had 2 weeks of level 3. Contact free takeaways were allowed here.

Then a month of level 2. Restaurants we're allowed to reopen with groups up to 10. Then they relaxed the rules to allow groups of 100. Schools reopened and business were allowed to reopen. You had to sign in at restaurants.

Went to level 1 on midnight Monday. Mostly border controls.

American lockdowns seem to be our level 2.5. Big box retail didn't reopen until level 2, takeaways and delivery were allowed level 3.
 

NotAYakk

Legend
Most of Ontario just hit level 2.5 NZ (schools closed, groups of up to 10 allowed outside home, hair salons with PPE, etc). Toronto and some areas near the USA are excluded.
 

American lockdown is very lax. It will reduce the spread but won't choke it off.
Yes, but that's more than a bit of an understatement. A more accurate statement is "The American lockdown was a disaster that reduced the spread of Covid-19, but was not initiated soon enough or broadly enough to be effective to the point that was needed."
 

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