Fauci warns 'little spikes' of coronavirus could turn into outbreaks if states reopen too soon
Also during the hearing, Republican Sen. Mitt Romney called the Trump administration's testing efforts "nothing to celebrate whatsoever."
It’s always going to be “too soon” unless herd immunity is achieved.
Let’s suppose that 1 infected individual somehow enters a susceptible population (meaning a population that is not immune to that infection) and that no control measures are in place. And let’s say that this infected individual can infect 3 susceptible people and that those 3 people can then infect 3 more people each. If we would express this in epidemiological terms, we’d say that the basic reproduction ratio (Ro) for this infection is 3. Whenever Ro is greater than 1, we expect the number of cases to increase exponentially, leading to an epidemic (for SARS-CoV-2, Ro is estimated to be around 2-3). In contrast, an Ro equal to 1 means that each infected individual can transmit a disease to 1 person only (the number of cases in a population would therefore remain constant over time).
So, in the above scenario we have a patient zero, able to infect 3 other susceptible individuals (let’s call them contacts A, B and C) who in turn infect 9 more people. Those 9 people infect 27 people and on and on it goes (until the pandemic has run its course). Now consider an alternative scenario, one in which 2/3 of that population are immune (therefore not susceptible to the disease and not able to transmit it to others). It would follow that 2/3 of the people that patient zero would normally infect are now immune, leaving just one person (say contact A) susceptible for an infection. Likewise, contact A would also be able to infect 1 person only. This resembles a reproduction ratio equal to 1, stabilizing the disease in a population. It also means that all the people that patient zero could have indirectly infected (via contacts B and C) are now protected. This is called herd immunity. We can estimate what percentage of the population must be immune in order to create herd immunity by using the formula (Ro-1)/Ro. In the case of Ro=3, that percentage is 2/3 = 66.7%.
Theoretically, we could achieve herd immunity by letting the virus burn through the population unchecked. This would of course be disastrous as 66.7% of the population would have to get infected, skyrocketing the number of people in need of hospitalization and mechanical ventilation beyond the capacity of any health care system. That’s where lockdowns come in, slowing down the rate at which people get sick (flattening out the curve) in order to keep the wheels turning long enough for a better way of establishing herd immunity to be found (mostly vaccinations, maybe prophylaxis). Unfortunately, coming up with an effective and safe vaccine will likely take a while. Until then, as more and more unexposed people are coming out of lockdown, a second wave should be expected so it should be done in a controlled manner and with the understanding that we’re in no way out of the woods yet.
And unfortunately, I have heard of nobody making periodicity a component to re-opening plans. Generally, the incubation period is about 2 weeks, thus if a 2-week cycle were included in these plans, it should be feasible to control in a more conservative way, in order to keep healthcare systems from being overwhelmed. I think it would also offer a more stable path to herd immunity in the absence of a vaccine or prophylaxis, and more stable economic activity.
I live in GA which almost fully opened on May 1. Since there is no obvious enforcement of social distancing, as a
“requirement” for businesses to open, people are acting like the pandemic is fully over. The numbers might tell in another week or so. We will see. I plan on sequestering at home for the long haul, being high risk, and wanting to live a bit more.
My part of the state is opening slowly, in phases, with checkpoints.
Luckily, I live in a civilized state and the governor has said end of the month maybe open in baby steps and then see. Putting an economy against a pandemic is pure insanity. Guess who will win and it won't be us humans.
@FearlessFly Thanks for the info. I get regular Inslee updates and even updates from Jenny Durkan mayor of Seattle. None of this affects me so I usually just glance at the reports.
I will be sticking 99% to home & wearing a facemask when I go out...I ain't no canary in a coal mine!!!!!
Yes, because it is Texas. Nuff said.
. . . have you read my response to Lauren (directly below) ?
Texas is ... being Texas. Most everyone I know thinks it's too soon (as do I), including a good number of people I know who are forced to be working, many without adequate protections. Mask and glove usage is erratic and becoming rare. I'm just watching the tally of sick and dead add up, and wondering why this isn't shocking more people.
Texas -- sigh.
(off topic soapbox)
Texas should learn humility, or Alaska will split in two and make Texas the third largest state.
. . . and I'll believe corporations are people when Texas executes one !
I'm in one of three regions of NY state that are doing a "phase 1 reopening" in a few days, based on low numbers of cases basically. I think it's too soon because I don't see what's changed in terms of my own risk of contracting the illness or being damaged or killed by it. There's no vaccine, testing is half-assed, we don't understand the etiology of the disease really and there are no effective and accessible treatments. If anything, the situation is overall worse than when the state went into lockdown, in terms of any random person's risk walking around on the street and going into grocery stores, etc., of being infected. The only thing I can see that has improved, if authorities here are to be believed, is that there's decent contact tracing in place, as that was one of the checklist items to allow us to begin reopening. But that's no help with my actual risk exposure.
As far as I'm concerned I'm on self-imposed lockdown for the foreseeable future. YMMV. I am at-risk, which provides the motivation, and am a 100% telecommute, which makes the decision easy.
I think @Spinliesel is in that area also . . .
What are the "decent contact tracing" mechanisms ?
@FearlessFly For all his elitist ass-hattery, Gov Cuomo has put forward a fairly coherent and specific set of requirements for phased lifting of the quarantine. I haven't read up on it in detail but I'd presume the contact tracing is a matter of having the personnel and an approved system in place and demonstrating readiness.
I see most of the pressure for re-opening coming from business interests, despite that they've gotten way more support than individuals, who, ironically, overwhelmingly think the lockdown is a good thing and shouldn't be prematurely lifted. I'm probably representative of the latter; I am concerned about actual personal and family risk, and am not interested in the concerns of people who have bad hair or are jonesing for their favorite bistro. I have concerns for people running out of $ but feel the government has failed to remedy that. We've given so much money to the corporate world that we could have put $30K in the hands of every taxpayer in 'Murica by now.