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California’s Roadmap to Modify the Stay-at-Home Order [pdf]

gov.ca.gov

31–40 of 406 posts

Re: California’s Roadmap to Modify the Stay-at-Home Order [pdf]

#31
post #4

I’d like to see something that’s clear and doesn’t risk so much on rapid accurate testing and tracking of... everyone with significant delayed feedback. Something that could be done in rural areas or even developing countries. A reliable next step in the Hammer and the Dance. I found this: http://pandemicbreak.org/

Consider that contact tracing was what worked reliably against Ebola. Those outbreaks took place in rural areas of developing countries. South Korea is having excellent success with contact tracing and quarantine.

You do ask what billionaire funds that website you cite. No contact details usually indicate a Citizens United style slush fund.

Re: California’s Roadmap to Modify the Stay-at-Home Order [pdf]

#32

I personally think we need a county-by-county approach. There is a high variation of the infection at local levels. All the news is currently about how bad New York is and it's true but we're not all New York. http://www.countycovid19.com/

In all sincerity, New York wasn’t Wuhan either. If I were any any other state, I’d absolutely limit travel from NY and screen them.

Really? New York current has quite a few times the casualties of all of China (10834 vs 3341) with a small population than Wuhan and the casualties haven't stopped there. New York by itself has one of the high casualty levels in the world by any measure.

Re: California’s Roadmap to Modify the Stay-at-Home Order [pdf]

#33
post #26
post #9

Earlier quoted context omitted.

It's true that regions are different, but I don't see how that translates. Can you be specific? How would a plan for Queens County, NY differ from one for Waukesha WI, except in trivial stuff like dates? Some outbreaks are smaller, but you'll note that they all leveled off at roughly the same time and on the same schedule. That's because we locked down on "New York's schedule"[1]. If we didn't, these places which see…

Different regions have dramatically different population densities, and don't necessarily need shelter-in-place rules. In NYC, shelter-in-place is probably the only feasible way to reduce social interactions when case-count is exploding, but in Boise, where people mostly live in detached housing and drive cars and cases are measured in the hundreds, it might be sufficient to eliminate large gatherings and shut down r…

> don't necessarily need shelter-in-place rules

Is there a cite for that? Because that's not the way the data looks.

Everywhere was growing with roughly the same exponent before lockdown. The numbers were bigger in NY because it grew longer pre-detection, but there's no reason to believe that everywhere else was any different. Really this disease's growth constant looks shockingly consistent almost everywhere in the world.

> It's unclear to me why we're making these policies at a federal level.

We... aren't. Literally every existing lockdown regime is being enforced at the state level or lower. For the Boise example you mention, the relevant regulation is a stay in place order from Gov. Little in late March.

Edit to show the point better: Go here (easily the best visualization site, FWIW), scroll to the bottom where you can see a log chart of per-capita infection rates normalized to a single "start time" metric, and compare the Idaho chart with the New York one.

https://91-divoc.com/pages/covid-visualization/

They are almost exactly the same chart, modulo a vertical offset and a kink in NY data in the second week (which consensus says is the testing backlog finally catching up).

If Idaho's detached housing and automobile dependence was reducing its rate of infection spread, it should be visible in the slope of this line. And it clearly isn't.

Re: California’s Roadmap to Modify the Stay-at-Home Order [pdf]

#34

I personally think we need a county-by-county approach. There is a high variation of the infection at local levels. All the news is currently about how bad New York is and it's true but we're not all New York. http://www.countycovid19.com/

I live in Nevada County, which apparently has a very low infection rate (34 cases, none in the last week) but if you open this county, what prevents folks from other countries from flooding in and bringing more infection? This county was previous a tourist mecca so it would be especially inviting. But any county that was open would be an appealing destination for the closed counties.

Nevada County is a particularly good example here of one of the failings of a county-by-county approach because Sierra Nevada Memorial Hospital there isn't really equipped to deal with a large number of critical care patients, and neither are many other rural counties. It would take far fewer cases to incapacitate Nevada County's health care infrastructure than Placer County or others to the west.

Re: California’s Roadmap to Modify the Stay-at-Home Order [pdf]

#35
post #3

Am I missing something? I don't see any kind of roadmap in here - it's just 6 generic talking points without any actual plan or timeline.

Can't have antibody testing to determine who is immune and can get back to work, can't have antigen testing to know who needs to quarantine, can't have government support for those who are off work because of quarantine, can't have support for undocumented workers who make up a good proportion of the workforce in some industries. Not going to work.

Re: California’s Roadmap to Modify the Stay-at-Home Order [pdf]

#36

Earlier quoted context omitted.

In all sincerity, New York wasn’t Wuhan either. If I were any any other state, I’d absolutely limit travel from NY and screen them.

Really? New York current has quite a few times the casualties of all of China (10834 vs 3341) with a small population than Wuhan and the casualties haven't stopped there. New York by itself has one of the high casualty levels in the world by any measure.

Higher reported casualty rate.

Re: California’s Roadmap to Modify the Stay-at-Home Order [pdf]

#37
post #30

This entire plan is based on models that do not align with what we are seeing. The graph on slide two[1] of the official CA govt plan shows hospitalizations With Intervention rising exponentially, exceeding our hospital capacity in early June. The actual new infection data shows that the rate of new infections has been decreasing since at least 4/4 [2], meaning that the graph of active hospitalizations should be a be…

> The graph on slide two[1] of the official CA govt plan shows hospitalizations With Intervention rising exponentially

It does not. The exponential curve, per the graph legend, is what would be expected without intervention.

Re: California’s Roadmap to Modify the Stay-at-Home Order [pdf]

#38
post #16
post #12

Earlier quoted context omitted.

Problem is the travel between counties, at least in CA. There's a lot of travel that could cause reinfection.

I'm not too sure reinfection is as important mathematically as some think when you realize the goal will be to operate below a threshold of cases, not eliminate covid entirely.

Reinfection is only unimportant if you don't have a large number of people who are going act to reinfect. If you do have a large number of infections, then of course refection is going to matter. And we do have a large number of cases in the most affected counties.

Basically, just like you don't want to overwhelm hospitals, you don't want to overwhelm your contact tracing infrastructure

Re: California’s Roadmap to Modify the Stay-at-Home Order [pdf]

#39
From indicator #1:

> How prepared is our state to test everyone who is symptomatic?

Another view is that opening the economy should involve testing people who are NOT symptomatic.

Quoting from an MIT Technology Review article (https://www.technologyreview.com/2020/04/08/998785/stop-covi...):

> The key, says Romer, is repeatedly testing everyone without symptoms to identify who is infected. (People with symptoms should just be assumed to have covid-19 and treated accordingly.) All those who test positive should isolate themselves; those who test negative can return to work, traveling, and socializing, but they should be tested every two weeks or so.

...

> He calls the $2 trillion legislation passed by Congress “palliative care” for the economy. If you took $100 billion and put it into testing, he says, we would “be far better off.”

Obviously for medical intervention purposes, you need to sometimes test people with symptoms. But for epidemiological and economic ones, it may be more important to test those without. So maybe neither is wrong, just different purposes.

Incidentally, the same article presents a reasonable argument that while keeping the economy shut down causes damage, opening it too early might cause more long-term economic damage than it prevents in the short term. If so, choosing between the economy and saving lives might be a false choice.

Re: California’s Roadmap to Modify the Stay-at-Home Order [pdf]

#40

> Slide 1: How prepared is our state to test everyone who is symptomatic? Positive tests could trigger notifications based on data collected by voluntary contact tracing apps. By only testing the symptomatic, mathematical models will continue to lack data for the subset of population that is already immune. We also need to test asymptomatic cases that would benefit from therapeutics which work best in early stages. W…

Yes, each county should have the ability to send sms messages countywide via their emergency management body.

That already exists.

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