Covid19

[Chik]

I have been struggling to fully grasp the logic behind (re)opening schools (in places other than Taiwan and the like) strictly from a public health (physical, not mental) standpoint. Could someone please explain?

What I think I understood so far is that young children, who I believe are prepubescent children, have:
* a very low likelihood of developing symptoms even when infected;
* a very low likelihood of transmitting a large enough dose to others in daily contacts, including adult members of their own household, even those with underlying conditions.

I included that last bit about underlying condition because if one were to include obesity as a condition, the implications in countries like the US and the UK are significant either way.

[echappist]

@Too Tall, thanks for the kind words. Happy to be accepted as part of the community.

[htwoopup]

I am no expert in this stuff, but I am a fan of facts and data. It seems this is facts. It is definitely data. Putting some numbers on how spread happens which means you can do numbers on how to limit spread and what the « customers » trade off is.

The layman’s article that turned me on to it is here:

https://www.nytimes.com/2020/11/10/h...fections.html?

The study itself is here:

https://www.nature.com/articles/s415..._reference.pdf

[Saab2000]

My 83 year old mother lives in a retirement cooperative just a couple blocks south of Minneapolis (66th and Lyndale for the locals) and all year long they've had no COVID cases. Then about 2 weeks ago she reported they have their first case. Then we chatted a few days ago and it's up to about 8 or 9 cases. Last evening my brother in St. Paul reports that of those cases several are hospitalized and one has died. The fatality was in fact a neighbor of my mother a couple doors down on the 7th floor and was a friend and also the president of the cooperative. Her husband is also hospitalized.

My mother is a life-long health care professional and worked in the operating rooms at the U of M in some of the pioneering open heart operations. Had it been more common in her era I'm convinced she would have been a surgeon instead of an RN but that's the sign of those times. She knows the science of disease so she's taking this seriously. But she has been challenged at times with the mental challenges many face and this isolation has been tough on her I think.

I was invited to drive up for Thanksgiving but decided to pass on this because I think right now is not the time for this type of gathering, especially in her situation and/or with my brother and his family. She struggles with this because family is also important. How to balance the needs of mental health and the pandemic? Not looking for an answer. But it's something we are all facing. I've been home alone for over a week now since my last travels but I think I'm laying low for now.

We chat often, as do all members of my family. We are extremely fortunate to not have any feuds and I'm close to both of my brothers and my sister and we chat amongst ourselves at some level probably almost daily. So we take care of each other pretty well. I am thankful daily for the technology that allows cheap, endless conversations and even video calling across oceans. During my childhood a 5 minute call to Europe was like science fiction and expensive and scheduled in advance. Now it's spontaneous and virtually free.

Attached to her building is the local chapter of the VFW and she speculates that's where there's more contact than is considered wise today. Residents of her building drop in, as do outsiders. Considering her building has strict policies on outsiders entering, I'm guessing that this is the source. My mother is normally not a regular at the VFW but I'm sure she socializes with some who are.

No answers or questions. We all know the right thing here. But it's a difficult balance for those at risk to choose between loneliness and friendship, knowing that both can have serious consequences.

Just my $.02 this evening as we are having this big spike.

[echappist]

s*** man, that's terrible to hear. Best of wishes to your mother.

I was a bit shocked when Minnesota overtook Wisconsin on the per capita rolling average new infection charts, and we (even Madison) are doing pretty terribly...

My wife's parents are in Philly; my dad is in South Carolina. Haven't seen any of them face to face since last Thanksgiving. We'd love to go and visit, but it's probably too tall an order right now.

[jimcav]

I have been struggling to fully grasp the logic behind (re)opening schools (in places other than Taiwan and the like) strictly from a public health (physical, not mental) standpoint. Could someone please explain?

What I think I understood so far is that young children, who I believe are prepubescent children, have:
* a very low likelihood of developing symptoms even when infected;
* a very low likelihood of transmitting a large enough dose to others in daily contacts, including adult members of their own household, even those with underlying conditions.

I included that last bit about underlying condition because if one were to include obesity as a condition, the implications in countries like the US and the UK are significant either way.

so Chinses study saw SARS-CoV2 positivity rate of 8% in students vs 13% in staff, so yes, a bit lower rate of infection, but not at all clear they don't transmit it.
English study (over 9 MILLION subjects) noted if you lived with kids under 11, your outcome was a little better IF you got COVID-19 (but no significant change in odds of getting COVID), and if you lived with kids 12-18, you had slightly increased risk of getting COVID-19. This is just an association/correlation--it doesn't really explain causation, but points to better outcome if you get COVID-19 and have younger kids, and slightly more chance of getting it if you have kids 12+.
Very small (35 cases) Chinese study showed 40% of kids with a parent with C-19 had asymptomatic infection. All those infected had virus shedding via respiratory and GI--average of 18 days.

you can find other studies out there, but general take now is kids get it, they are LESS symptomatic, and they CAN transmit it. The 18-39 ages tend to be the bigger spreaders, from various mobility tracing studies I've seen.

However, now that the virus is so completely widespread in the USA, less mobility is needed and now it will be simple gatherings that keep it finding new hosts. Brace for deaths @ 2k a day in about 2 weeks. If folks aren't careful/cautious at Thanksgiving, there will be another rise in hospitalizations going into Christmas, with a bigger spike in deaths in January.

[jimcav]

She knows the science of disease so she's taking this seriously.

this and your (family) support is key. I hope you all enjoy a fantastic Holiday season in 2021

[beeatnik]

teeaitch, thoughts on this:

https://www.cnn.com/2020/11/19/us/gy...rnd/index.html

[thollandpe]

teeaitch, thoughts on this:

https://www.cnn.com/2020/11/19/us/gy...rnd/index.html

Wow! That’s exactly what I’ve been doing since March. Only one athletic facility, and a whole lotta classrooms, lecture halls, and courthouses.

That really is the basic, step one recommendation: adequate ventilation. Kudos to them for tracking it by measuring CO2.

It’s extra frustrating since I got the ASHRAE position paper in March, but it was never rolled out by the feds in a concerted, centralized effort to help schools and businesses. It was up to individual building owners, and smart businesspeople like her, to hire professionals and figure it out on their own.

[thollandpe]

And every recommendation I have been made has included the following caveat and quote:

Mechanical ventilation is a secondary concern, as the primary risk of virus transmission is through other means.

"Basic principles of social distancing, surface cleaning and disinfection, handwashing, and other strategies of good hygiene are far more important than anything related to the HVAC system."
— Lawrence J. Schoen PE (ASHRAE Journal, May 2020)

And every client facility I've entered since March has asked me the questions before letting me enter, and most have taken my temperature, or I've had to self-certify by answering no to all the questions on an online form:

Within the last 14 days have you...
...had any of the symptoms (cough, difficulty breathing, fever, fatigue, chills, aches, sore throat, congestion, a new loss or change of taste or smell, gastrointestinal problems)
...or anyone in your household or that you care for, or any partner, been diagnosed with or believed to have COVID-19?
...been within 6 feet, for 15 minutes or more, of a person confirmed or believed to have COVID-19?
...had direct contact with the bodily secretions of anyone diagnosed with or believed to have COVID-19?
...been directed to quarantine or isolate by any Department of Health or healthcare provider?
...traveled to an area currently under a travel advisory by your home state?

[jimcav]

teeaitch, thoughts on this:

https://www.cnn.com/2020/11/19/us/gy...rnd/index.html

that's pretty misleading title to that article. Getting "sick" really less than half the issue. There were 50 potentially exposed and "a few got tested" so they really have no idea who might have actually been infected, asymptomatic, and transmitted it. That in essence is why we are where we are--few know their status, and enough are making bad assumptions and running around NOT adhering to best-practices to limit spread, to the point that the virus is now widespread.

[beeatnik]

that's pretty misleading title to that article. Getting "sick" really less than half the issue. There were 50 potentially exposed and "a few got tested" so they really have no idea who might have actually been infected, asymptomatic, and transmitted it. That in essence is why we are where we are--few know their status, and enough are making bad assumptions and running around NOT adhering to best-practices to limit spread, to the point that the virus is now widespread.

That's one way of looking at it.

[jimcav]

just pointing out that "sick" isn't a good benchmark due to asymptomatic spread. Be nice if they had hard data from testing, or that all 50 quarantined long enough to ensure no spread in the absence of good testing.

[thollandpe]

I’m in agreement with you there, Jim. And the premise is flawed from the outset because you can’t prove a negative.

But I am encouraged that a business actually looked at the guidelines and implemented some. It’s frustrating to see how many schools and businesses are not. Many schools just don’t have the resources anyway.

Here’s a sobering assessment, A traveler tested negative for covid-19 before a flight. He had the virus and infected 4 passengers.

Damn. I guess you can move, exchange, and filter the air all you want but physical proximity and exposure time are two major factors.

And nice work, New Zealand. The only way we know this is because of their strict and realistic quarantine policy. Imagine how many infections those four would have become had they gotten off the plane in the US.

[jimcav]

100% agree with you--it is so worth the effort to do everything you can to mitigate spread, and it would be so nice if the fed. gov't had worked to make the infrastructure possible to make it all work. Instead we are mainly stuck reacting when hospital cases and deaths surge.

[j44ke]

Local high school announced on Friday they have 2 students and 2 staff members positive for covid19 with 13 students and 6 staff quarantined as a result. If any in quarantine come up positive, then there will be another round of quarantine selection.

This is one of those typical rural schools where a number of towns have agreed to send all their kids to a central facility for K-12 and share the cost of education and infrastructure. So infections there could definitely impact quite a bit of the county.

[rwsaunders]

I watched some of the college football highlights this evening and it went from no fans and families members allowed to attend the Buckeyes/Hoosiers game at The Shoe, to what looked like half of the state of Oklahoma going to the Sooners/Cowboys game, which is noted to have “limited in-person attendance”...20,000.

[Saab2000]

Meanwhile, we are seeing vaccines with high efficacy rates nearing production and distribution. Anyone care to comment on general availability? I would think the first distribution should begin in December. Curious how this all goes and when we will begin to see results with infection curves, etc.

I know nothing but what I read in the various news sources I frequent. But the news on the vaccine front appears to be generally positive.

[Doug Fattic]

At 1st the statistics of Covid 19 infections seem like rather abstract numbers - more in some places and less in others but not affecting me. Lately a # of my friends and acquaintances have tested positive - people who I have had regular contact with in the past. Some of them have had to be hospitalized. It has always seemed real but now it is more threatening.

[bigbill]

Mohave County, AZ, where I live, set a new record for infections in a week. Five hundred new cases with three deaths, but given the two week delay between diagnoses and possible death, the death number will likely spike the first week of December. The hospital in Kingman is where the cases requiring hospitalization are treated. The good news is a large availability of ICU beds and ventilators. The majority of cases are largely asymptomatic and linked to others.