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can we stop COVID-19 ?

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  • can we stop COVID-19 ?

    this is bizarr.
    WHO says it can be contained but countries are not doing it.
    They seem to disagree but don't say why. There is no discussion.
    There is no talk in the media about China's success and WHO's
    almost desperate continued calls to repeat it.
    16:34-UTC , WHO calls it a pandemic
    “We’re deeply concerned both by the alarming levels of spread and severity
    and by the alarming levels of inaction,”
    several countries have demonstrated the ability to suppress and control the outbreak,
    Tedros scolded other world leaders for failing to act quickly enough or drastically
    enough to contain the spread.
    All countries can still change the course of this pandemic,”
    We are grateful for the measures in Iran, Italy, Korea.
    # they seem to disagree, but there is no discussion about the reasons
    # I wonder who is "we", when Tedros says "we" and whether they consulted
    # with the world's politicians and experts
    China extended the holidays, people didn't come to work.
    Except the essential business. In some cities they also reduced public transport,
    there was massive contact-tracing, fever screening ...
    See the WHO chinese mission report [link].
    And it went down everywhere, all provinces,
    In Wuhan it took 1-2 weeks longer than elsewhere..

    Yes, it's bad for the economy but so is it to do nothing or not enough.
    US,EU Stocks fell >20% and are now worse than the Chinese markets
    which recovered.

    I assume, people will stop coming to work anyway in some weeks,
    most schools will be closed, events canceled, compare with 1918.
    But will they stop cars, control shopping, fever screening and that ?
    And they almost already gave up contact tracing, it requires cooperation.
    But when we are at that point it will be already very bad here, very hard
    to stop it, see Wuhan. "speed is everything" says WHO.

    Wuhan got much help from China, HCW teams, food.
    Now it looks as if here it will be much worse than it was in Wuhan.
    >5 million deaths in USA if it continues this way.
    Well, at some point people _will_ probably stay at home, the economy collapses.
    Hospitals anyway.
    How long can that go without help from outside ?
    Until summer, when maybe it slows down if we are lucky ?

    I'm interested in expert panflu damage estimates
    my current links: ILI-charts:

  • #2
    Taiwan, South Korea, Hong Kong, Singapore have all demonstrated that it can be slowed down enough that it can be stopped. It requires significant action and behavioral changes, but it doesn't require the full lock down measures adopted by China (which does also work btw).

    I want to see all governments make the following crystal clear for all their populations:
    Implement social distancing. Ban gatherings, events, etc.

    If you are in a non critical employment situation, please stop working or work from home. All employers must allow this option without penalty and all employees who are unable to be paid will be guaranteed a minimum wage payment by the government.

    Avoid face to face meetings, do NOT hug, kiss or shake hands, don't even approach the other party in public settings. Ban use of transport networks UNLESS you are correctly wearing a face mask (surgical is ok), regardless of no symptoms.
    Stop travelling. If you travel, self quarantine for 14 days, regardless.

    Train everyone in hygiene practices, hand washing with soap (explain why, fat lipids), provide masks, gloves, hand sanitizer on a per household basis. Run education videos explaining how to perform and use these hygiene products correctly.

    The government should be talking to the hospitality industries, asking them to consolidate guests into one property and make the other properties available to the government as emergency hospital facilities. Talk to restaurants, train them in the use of PPE and hygiene practices and have them prepare meals for all the hospital, medical, contact tracing and front line personnel. Any company assisting in this manner will receive payment for services (reduced rates) and a tax holiday for the entire period of support.

    Talk to logistics and transport companies, arrange to fill spare capacity to move urgent and necessary goods. Have similar incentives as above.

    Do this now and do this everywhere and we can kill this sucker. Trying to save the economy with stop gap measures or by ignoring public health risks, will only jeopardize the whole economy overall. Focus on people and the economy will recover.

    Edit: and test. Test, test, test. Use PCR but also use CT scans. 4dx propose their technology can be used for alternate rapid diagnosis. Be flexible, be creative.

    My 2c


    • #3
      Thanks for the comments, mscox. Those are all good suggestions that could slow the spread of this pandemic.


      • #4
        I would agree entirely with you mscox, but what argue that it wont be possible to eradicate due to issues with the developing world. Some pockets of infection would always remain.

        However, it would be possible to reduce cases to a trickle, which could then be managed if countries maintained and managed very strict contact tracing for all travellers.

        That means:
        1. Every plane ride is accompanied with a questionnaire that must be completed and gives contact information for the traveller who is then followed up by phone by local authorities at 3, 7, 11 and 15 days to ensure no development of symptoms. When cases are found, ruthlessly effective contact tracing and isolation of contacts is carried out.
        2. an instant test is needed that is held by GPs, hospital docs, pharmacies or for self purchase and self testing - so that it can be rapidly identified in anyone and is carried out AS ROUTINE in every case of cough, cold, fever or myalgia.
        3. Most countries do not have domestic mask production. There are simply not enough masks to carry out this idea. There are currently not enough for countries individual populations, let alone healthcare providers at this stage. However, creation of such facilities with production capacity sufficient to stock a country with a population of 60m should not be beyond the capabilities of the developed world, or with help, the undeveloped world. Then this could be done, and it could be made obligatory for masks to be worn any time there is an epidemic alert by everyone to help slow transmission until local eradication has been completed.
        4. Economic studies are required that can show governments that the costs of not doing the initial total shut down (global) will cost their country more in terms of economic impacts and health impacts than doing nothing at all. I am pretty sure if this was modelled over a 1, 2, 5 and 10 year span, the case would be pretty clear even if payment of funds are needed for the self employed, low paid etc.

        In that way we could keep on top of this until a treatment or vaccine is found / developed that could then be used to eradicate this. Our alternative is (most likely) to keep going through this each year until the world's population has developed sufficient immunity to reduce it to nothing more than a common cold, however long that takes. It would also risk mutations that create MERS like levels of virulence from time to time. It could also change to attack our children and spare the elderly in a future iteration.

        We cannot do this in time for this wave; it does not mean that we should not strive to be able to do this for the future, because the above risk is real.


        • #5
          it is a general misbelief that China contained it with "lockdowns". While that is true for Hubei, they contained it in the rest of China
          mainly with other methods.see
          This argument was often used as an excuse that we can't do the Chinese measures, recommended by WHO here in Europe and USA.
          Well, it took some weeks until the Chinese success was even acknowledged. Even as late as the start of that WHO-mission
          linked-to above some members were still skeptical.

          We have no Wuhan in USA. And in Europe we had the immediate lockdown of 10 smaller cities in Italy.
          But we _still_ couldn't stop it so far. Starting from almost zero on Feb.21 while ChinaExHubei started from ~700 new cases
          per day in early Feb.
          Now, is it too late ? stocks are down another 10% , now -35% since Feb21
          We are maybe now, where Hubei ex Wuhan was in early Feb. , 1-2 weeks worse than ChinaExHubei
          Measures are increasing
          I put my daily upates here :

          I'm interested in expert panflu damage estimates
          my current links: ILI-charts:


          • #6
            The problem is, for many countries whose health systems will be overrun by this outbreak, we will look back and know that "it didn't have to be this way"....


            • #7
              STAT-article on how it spreads
              Some things are a bit unexpected and surprising


              Transmission in China happened among family members and close contacts.
              True “community spread” was less common.


              so, that seems to suggest that isolating suspected household members
              in isolation clinics and contact-tracing is the right method.
              As it will be enforced by the army in Iran now in the next 7-10 days.
              As it was done in China (I think. At least in Wuhan , they gave daily numbers
              of contacts traced, people "concentrated" ; they had fever-clinics, mobile isolation points)
              I'm not sure how South Korea handled this.
              It isn't done in Italy, AFAIK (so far).
              And it is unpopular in USA, I remember that discussion from the H5N1-forums >10 years ago.

              so, how did it transmit from household to household ?
              Friends visiting ? Birthdays,weddings,funerals
              From work ? Collegues, customers, coworkers, clients, conferences
              Public transportation ? subway, buses, trains
              Mechanics in the lodgement? repairs
              Sewage, water ?

              I'm wondering ... is it maybe exactly this isolation of suspected household members,
              separating them from their family ,
              which is the key to contain it ?
              Part of China's success, now implemented in Iran,
              so unpopular in Europe,USA.
              And maybe that's the reason why it isn't being
              discussed here. Why it is being avoided.
              So authoritarian, so communist, so unfree.
              all the old people in Italy, how did they get it ?
              Probably not from traveling, probably not from work or school.
              But from household contacts. Italy is known for their grand-families
              several generations in the household.
              I'm interested in expert panflu damage estimates
              my current links: ILI-charts:


              • #8
                "flatten the curve" had been a popular "hashtag" at twitter.
                I don't see the point

                here a STAT-article from Mar07:

                I don't see that debate "containing" vs. "mitigating" , where is it ?]
                and why does Ryan think it is not helpful ??? it's important !

                mitigating has only a small effect. Every measure helps only locally
                for the purpose that it was intended for.

                while containing has a potentially exponential effect. Exponential preventing , that is.
                And it does work in theory.

                Let's get over these legal and constitutional hurdles to get it working in the "Western World"
                as it did in East-Asia..

                We don't need an original national approach, adapted to our culture and ethics ;
                we rather need a _working_ approach. Let's get some Chinese and Korean consultants into our crisis management.
                I'm interested in expert panflu damage estimates
                my current links: ILI-charts:


                • #9
                  "We don't need an original national approach, adapted to our culture and ethics ; we rather need a _working_ approach. Let's get some Chinese and Korean consultants into our crisis management."

                  This! Especially the Korean and the Taiwan experts. They have managed their outbreaks within a high functioning democratic society.


                  • #10
                    I also think face masks, the basic surgical kind, when used correctly and ubiquitously, are quite key to preventing spread. This is something that western cultures don't embrace, and western governments, incorrectly I might add, advise against. I think this is the big change we just have to accept.

                    It is just for a few months after all, and surgical masks should not and are not expensive.


                    • #11
                      it had been estimated that surgical masks prevent ~65%? of spread and N95s ~85%? , I wished I had saved the link.
                      Also one study showing masks are more effective against SARS than flu , presumably because they prevent the wearer
                      from touching his face.
                      Reports are that respiratory transmission is confirmed but by touching surfaces is not confirmed.
                      Why can't they figure that out ?
                      From what other textile can you make masks, what about microfaser ? are 2 surgicals masks 1-(1-.65)*2=88% protective ?
                      I'm interested in expert panflu damage estimates
                      my current links: ILI-charts:


                      • #12

                        WHO: But we have not seen an urgent enough escalation in testing, isolation and contact tracing
                        not enough to extinguish this pandemic
                        Test every suspected case.
                        If they test positive, isolate them and find out who they have been in close contact
                        with up to 2 days before they developed symptoms, and test those people too.
                        [NOTE: WHO recommends testing contacts of confirmed cases only if they show
                        symptoms of COVID-19]


                        maybe WHO is not aware, that Americans (and Europeans ?) are very reluctant
                        to this isolating thing. I do remember, how controversial this was in the forums
                        in 2006-2007 with the H5N1 discussion.
                        "Taking away family members to isolation points"
                        It is somehow in their culture, in their history, in their education , I think.
                        This could be the key why the Chinese/Korean measures are not even
                        being mentioned and discussed and the reason why they ultimatively
                        fail in USA, Europe.
                        I'm interested in expert panflu damage estimates
                        my current links: ILI-charts:


                        • curiosity
                          curiosity commented
                          Editing a comment
                          It is so true!
                          Testing is our limitation.

                      • #13
                        We can't stop it without testing. Right now the disease is moving without testing. There is no way to tell how many "mild" symptomatic cases there are when only people in a severe state or with fever, cough, sob AND an association with confirmed case or travel are tested.

                        How on earth could we possibly know the 10 year old with a mild cough and sore throat is infected with COVID19 when we are not even testing them?

                        Incredibly disappointing response in the US.


                        • Missouriwatcher
                          Missouriwatcher commented
                          Editing a comment
                          One also may be a parent who thinks a mild cough and sore throat warrants no testing and kid goes on merry way.

                      • #14
                        Did you see the article showing the intense crowding at major airports in the US over the weekend cuing up to be screened? It was ridiculous. Even draconian measures can't contain it now. It's showing up virtually simultaneously across broad regions and all over the globe. It's likely it has been circulating since well before the December holiday season. The only thing we can do at this point is slow it down enough so we don't overwhelm the healthcare system all at once. I remember during the 2009 pH1N1, the UK hospitals at one point were seriously strained. Imagine if that had gone on for three to six months. That is what we could be facing. Hopefully, not everywhere all at once or a lot of people will die who could otherwise be saved.

                        I think the jury is still out on whether South Korea or Taiwan have successfully slowed it down or whether it will re-emerge in waves. That happened with the 1918 flu.
                        "I know God will not give me anything I can't handle. I just wish that He didn't trust me so much." - Mother Teresa of Calcutta


                        • #15
                          It is beyond testing and contact tracing now. Time to batten down the global hatches as much as possible, everyone implements social distancing and self quarantine/isolation, and we ride this out as best we can. Reducing the rate of spread is all that matters now. Just assume it's everywhere and do everything to prevent it spreading.