Shanghai Disneyland will close in effort to contain coronavirus

Just finished a community town hall for all faculty and staff at U. Michigan's College of Engineering. The bulk of the presentation came from Dr. Sharon Kardia, a Professor of Epidemiology. She presented a lot of good information from current public health understanding, and I thought it would be worth sharing some of what I learned here.

• The number one thing that came across: the primary means of transmission is person-to-person, at close quarters, for an extended period of time. For the purposes of contact tracing, a "high-risk contact" is someone you were within six feet of for 15 minutes or more. That standard has gone up over time; it was originally 5 minutes, was increased to 10 minutes, but evidence suggested that those times were short enough that risk was lower.
• It is airborne, but not highly aerosolized. There is no evidence for room-to-room transmission via HVAC systems, so increased filtration for recirculated air is not a significant need. However, moving air in and out of a space *is* important; stagnant air increases "dose intensity." So for example the College has disabled the occupancy sensors that manage variable-flow control systems, and just turned all of those to "on." Likewise, the HVAC system is now set up to start 2 hours before a building opens, and run until 2 hours after it closes. We are also increasing the volume of outside air exchanged in a space, even though that will increase our heating/cooling costs.
• Being immediately downstream (in an airflow sense) of someone who is infected does matter. Paraphrasing Dr. Kardia: "Don't go to a restaurant. If you do, try to sit right next to the vent so you are not downstream!" (My conclusion: restaurants are off limits for the foreseeable future.)
• She was not aware of a known transfer through surfaces, but hands-to-face transfer is a vector so handwashing is still important.
• The two most common infection sources are someone you live with, or a daily close work colleague. Next most common: public-facing service roles and health care from customers/patients. One consequence: no one in CoE will be at work five days a week, no matter what the role.
• Shared commutes (vanpools etc.) are also very high risk.
• Greatest reduction in risk: reduced density, physical distancing, masks, handwashing.
• Best things you can do for prevention:
  
  • Wear a cloth or disposable mask (correctly) inside *and* outside.
  • Maintain 6' of distance inside *and* outside.
  • If you observe someone coughing, sneezing, etc. just go the other way.
  • We are socially programmed to feel slightly uncomfortable at this distance. Get over it.
• We don't yet have good data on potential re-infection/immunity. Most likely several months between potential infections, but that is based on behavior of other viruses in this family. A positive antibody test does not indicate immunity--we just don't know yet.
• Compliance is an issue, we plan an intensive messaging campaign that emphasizes shared responsibility over shaming. We will also emphasize holistic well-being: getting exercise, good sleep habits, focus on mental health.

One other thing I thought was interesting: the current data suggests that kids from 0-9 tend to infect other family members less frequently than older kids/adults. The current hypothesis is that kids that age are too short to get virus particles through the air to adults as effectively!

(For context: For the '20-'21 academic year, most U-M classes will be distance-learning/virtual. A few labs, etc. that need to be will be in person, but at significantly reduced density and with enhanced PPE. Students are welcome to come back to campus, but are not required to.)

I think I found the July Coasterbuzz drinking game:

Take a shot every time Jeff mentions dry humping.

Also:

Halloween Horror Nights Cancelled

Definitely the right move. I can adapt a regular park day with the temporary normal. But there is no way to do HHN where it remotely would capture the spirit of the event.

No need to hate. If you disagree, I'd rather you just said you disagree.

It's Friday morning, what else have I got to do but play around with some numbers.

I grabbed the dataset from the FL DOH and made a few, most likely useless, charts.

This is deaths per age group. No surprise here, the elderly are far more at risk.

This shows of the confirmed deaths per age group whether or not they were in the hospital.

This shows for the confirmed hospitalized population whether or not they survived.

This shows cases vs. deaths per age group.

And this one is just a quick cases per county map because why not.

Yay data!!!

Jeff said:

No need to hate. If you disagree, I'd rather you just said you disagree.

I agree 100% with what you said. It was just a light hearted moment where I never would have imagined when I first started following this site 20+ years ago as a geeky coaster teenager than I'd be an adult with a job still reading the forums and the phrase "dry humping" would come up in a serious and legitimate manner while discussing a global pandemic.

There was zero hate intended there.

ApolloAndy said:

Also, also, it appears that isolating nursing homes from the rest of the population isn't working:
https://www.politico.com/states/florida/story/2020/07/15/florida-nu...us-1301255

I wish this article weren't behind a paywall.

It's titled, "The extreme strategies that saved some nursing homes from Covid-19" and the visible text reads:

When Tyson Belanger, the director of Shady Oaks Assisted Living, heard about cases of a mysterious respiratory illness that had entirely shut down Wuhan, China, it reminded him of his days in the US Marine Corps.

"I was deployed five times as a Marine," says Belanger. "And this felt like a sixth deployment."

By early March it was clear that screen visitors wouldn't be enough to keep the virus out of his facility in Bristol, Connecticut. So Belanger decided he would have to keep everyone at Shady Oaks in.

Seems to imply there was some success in the approach and I'd love the details. (especially as this is the approach I've been interested in for a while now)

Nothing else here really. If anyone has access to the article, I'd love a chance to read it in its entirety.

This is probably along the same lines with the same guy.

Incidentally, this is what's going on with a lot of au pairs that are hired to care for kids with severe disabilities. If they weren't cohabitating with those families, they are now.

The article Jeff posted was from April and was talking about running out of money to continue in early June. I’d be curious how sustainable auch a model is, but it doesn’t sound like a long term solution.

The nursing homes were running out of funding. But feds could help support (cash cannons are warming up again in DC). Could make it more sustainable for longer period of time.

Ohio reports cases in nursing homes. Both in the past week and cumulative (at least beginning April when stats starting being kept). For patients and staff. Its interesting in that different facilities in the same counties have very different numbers. They do not give per capita numbers so it may be the case that facilities with higher numbers are simply larger. About 70% of thet deaths in Ohio have been in nursing homes/long term care facilities. No specific numbers are listed for deaths by facility (only listed by county).

https://coronavirus.ohio.gov/wps/portal/gov/covid-19/dashboards/lon...ties/cases

Bad news (heart issues) and good news (virus mutation may make vaccines more effective):

https://www.reuters.com/article/us-health-coronavirus-science-idUSKCN24S2FC

Remember the lean toward old people? Well, now there are more hospitalized people under 50 than over.

https://gis.cdc.gov/grasp/COVIDNet/COVID19_5.html

That's not deaths. (which was the discussion, we never talked hospitalization)

And there could be a lot of reasons for that. Honestly, it has probably been true all along, just by makeup of the population.

Hospitalization is a serious problem and volume leads to lesser outcomes (more death). All of these factors matter. It's not just PPE that's in short supply, now we're facing a shortage of doctors and caregivers. There could be a lot of reasons for that... so what? That means we just ignore it?

Ok.

Still seems like looking for the worst. The balance of the age demo of the people being hospitalized (which we never discussed before) doesn't indicate anything about the actual numbers being hospitalized or their actual outcomes. In fact, the page you linked to shows the number of people hospitalized the week of July 18th (the most recent data) as a little more than 1/3rd the number hospitalized the week of April 18th.

1/3rd the people in the hospital with twice the cases is entirely consistent with my post from last week.

You might be putting data together on your own and reaching conclusions, but the post, "Well, now there are more hospitalized people under 50 than over." doesn't mean much on its own.

"Looking for the worst" is an emotional construct. It doesn't invalidate what is objectively observable, which is the complete failure of the United States to limit the damage. All of this data reinforces that we suck at this, and your laissez-faire dismissal of it doesn't help.

You're right, the data shows less aggregate hospitalization, because NYC has turned the corner, and other hot spots that are less populated have become the new problem. So you're wrong, it does indicate something about actual hospitalization, because it's relative to population and capacity.

I'll say it again, we have a pretty good understanding about how to reduce the blast radius of outbreaks, but we don't because selfish people and denialists won't do the most basic things to mitigate the problem.

I don't even know how to begin to unpack all of that.

Jeff said:

Well, now there are more hospitalized people under 50 than over.

Doesn't the hospitalized graph show that the number of hospitalized people >50 are still higher than <50? The latest week is about a 60%-40% split, with the majority being >50.

The % of <50 hospitalized has been increasing over the past several weeks which would be expected. I don't imagine the >50 crowd is doing the dry humping thing.

Lord Gonchar said:

I don't even know how to begin to unpack all of that.

I'll reiterate Jeff's most important point:

Americans are selfish.

I'll take it a step forward and say we are being empowered to be selfish by a great deal of our "leadership".

It's fun when any optimistic finding is met with "the US sucks at stuff," as if anyone is actually debating that.