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  • The rationale for contact tracing in the US

    Contact tracing could help avoid another lockdown. Can it work in the U.S.? | Stat | May 29 2020

    Contact tracing does not need to be perfect to make a serious dent in case counts. If the goal is to keep the number of people getting sick below the point where hospitals are overwhelmed — not to eliminate the virus — not every contact needs to be found and not every person needs to follow recommendations.

    If health officials can identify half of symptomatic cases of Covid-19 (some people don’t show symptoms), and trace 40% of their contacts, “the ensuing reduction in transmission allows the reopening of economic activities while attaining a manageable impact on the health care system,” a preprint of a modeling study found, relying on transmission dynamics in the Boston area.

    If tracing resources are limited, focusing on burgeoning clusters of cases can also be more impactful than taking aim at tendrils of spread, experts say.

    We’re not trying to get rid of Covid-19 altogether — that would be great, but probably unrealistic,” said infectious disease epidemiologist Emily Gurley of the Johns Hopkins Bloomberg School of Public Health.

    “But even if we can’t stop all transmission, it’s still a really important effort to keep case counts low.”
    What is a contact ?

    The Centers for Disease Control and Prevention says that in the case of Covid-19, a contact is someone who spent at least 15 minutes within 6 feet of a case, starting two days before that person started feeling sick.
    I find this definition interesting, it means to get infected that 15 mins is the minimum amount of time one requires to be exposed

    https://twitter.com/KeithNHumphreys/...28752516706304

    The why & why not for contact tracing in the US. The way he opens the debate make you think contact tracing will be a fools errand in the US.
    Last edited by Double Edge; 03 Jun 20,, 19:39.

    Comment


    • I Cannot Remain Silent
      ADM Mike Mullen (Ret.)
      Seventeenth Chairman of the Joint Chiefs of Staff


      It sickened me yesterday to see security personnel—including members of the National Guard—forcibly and violently clear a path through Lafayette Square to accommodate the president's visit outside St. John's Church. I have to date been reticent to speak out on issues surrounding President Trump's leadership, but we are at an inflection point, and the events of the past few weeks have made it impossible to remain silent.

      Whatever Trump's goal in conducting his visit, he laid bare his disdain for the rights of peaceful protest in this country, gave succor to the leaders of other countries who take comfort in our domestic strife, and risked further politicizing the men and women of our armed forces.

      There was little good in the stunt.

      While no one should ever condone the violence, vandalism, and looting that has exploded across our city streets, neither should anyone lose sight of the larger and deeper concerns about institutional racism that have ignited this rage.

      As a white man, I cannot claim perfect understanding of the fear and anger that African Americans feel today. But as someone who has been around for a while, I know enough—and I’ve seen enough—to understand that those feelings are real and that they are all too painfully founded.

      We must, as citizens, address head-on the issue of police brutality and sustained injustices against the African American community. We must, as citizens, support and defend the right—indeed, the solemn obligation—to peacefully assemble and to be heard. These are not mutually exclusive pursuits.

      And neither of these pursuits will be made easier or safer by an overly aggressive use of our military, active duty or National Guard. The United States has a long and, to be fair, sometimes troubled history of using the armed forces to enforce domestic laws. The issue for us today is not whether this authority exists, but whether it will be wisely administered.

      I remain confident in the professionalism of our men and women in uniform. They will serve with skill and with compassion. They will obey lawful orders. But I am less confident in the soundness of the orders they will be given by this commander in chief, and I am not convinced that the conditions on our streets, as bad as they are, have risen to the level that justifies a heavy reliance on military troops. Certainly, we have not crossed the threshold that would make it appropriate to invoke the provisions of the Insurrection Act.

      Furthermore, I am deeply worried that as they execute their orders, the members of our military will be co-opted for political purposes.

      Even in the midst of the carnage we are witnessing, we must endeavor to see American cities and towns as our homes and our neighborhoods. They are not “battle spaces” to be dominated, and must never become so.

      We must ensure that African Americans—indeed, all Americans—are given the same rights under the Constitution, the same justice under the law, and the same consideration we give to members of our own family. Our fellow citizens are not the enemy, and must never become so.

      Too many foreign and domestic policy choices have become militarized; too many military missions have become politicized.

      This is not the time for stunts. This is the time for leadership.
      _______________

      We have no leadership in this country. Nor will we until Donald Trump and his gang of fellow thugs and thieves are out of the White House permanently.
      “He was the most prodigious personification of all human inferiorities. He was an utterly incapable, unadapted, irresponsible, psychopathic personality, full of empty, infantile fantasies, but cursed with the keen intuition of a rat or a guttersnipe. He represented the shadow, the inferior part of everybody’s personality, in an overwhelming degree, and this was another reason why they fell for him.”

      Comment


      • James Mattis Denounces President Trump, Describes Him as a Threat to the Constitution

        IN UNION THERE IS STRENGTH
        I have watched this week’s unfolding events, angry and appalled. The words “Equal Justice Under Law” are carved in the pediment of the United States Supreme Court. This is precisely what protesters are rightly demanding. It is a wholesome and unifying demand—one that all of us should be able to get behind. We must not be distracted by a small number of lawbreakers. The protests are defined by tens of thousands of people of conscience who are insisting that we live up to our values—our values as people and our values as a nation.

        When I joined the military, some 50 years ago, I swore an oath to support and defend the Constitution. Never did I dream that troops taking that same oath would be ordered under any circumstance to violate the Constitutional rights of their fellow citizens—much less to provide a bizarre photo op for the elected commander-in-chief, with military leadership standing alongside.

        We must reject any thinking of our cities as a “battlespace” that our uniformed military is called upon to “dominate.” At home, we should use our military only when requested to do so, on very rare occasions, by state governors. Militarizing our response, as we witnessed in Washington, D.C., sets up a conflict—a false conflict—between the military and civilian society. It erodes the moral ground that ensures a trusted bond between men and women in uniform and the society they are sworn to protect, and of which they themselves are a part. Keeping public order rests with civilian state and local leaders who best understand their communities and are answerable to them.

        James Madison wrote in Federalist 14 that “America united with a handful of troops, or without a single soldier, exhibits a more forbidding posture to foreign ambition than America disunited, with a hundred thousand veterans ready for combat.” We do not need to militarize our response to protests. We need to unite around a common purpose. And it starts by guaranteeing that all of us are equal before the law.

        Instructions given by the military departments to our troops before the Normandy invasion reminded soldiers that “The Nazi slogan for destroying us…was ‘Divide and Conquer.’ Our American answer is ‘In Union there is Strength.’” We must summon that unity to surmount this crisis—confident that we are better than our politics.

        Donald Trump is the first president in my lifetime who does not try to unite the American people—does not even pretend to try. Instead he tries to divide us. We are witnessing the consequences of three years of this deliberate effort. We are witnessing the consequences of three years without mature leadership. We can unite without him, drawing on the strengths inherent in our civil society. This will not be easy, as the past few days have shown, but we owe it to our fellow citizens; to past generations that bled to defend our promise; and to our children.

        We can come through this trying time stronger, and with a renewed sense of purpose and respect for one another. The pandemic has shown us that it is not only our troops who are willing to offer the ultimate sacrifice for the safety of the community. Americans in hospitals, grocery stores, post offices, and elsewhere have put their lives on the line in order to serve their fellow citizens and their country. We know that we are better than the abuse of executive authority that we witnessed in Lafayette Square. We must reject and hold accountable those in office who would make a mockery of our Constitution. At the same time, we must remember Lincoln’s “better angels,” and listen to them, as we work to unite.

        Only by adopting a new path—which means, in truth, returning to the original path of our founding ideals—will we again be a country admired and respected at home and abroad. Link
        ______________

        Thank you General, it's about goddamn time that people of your stature speak up about the national calamity that has befallen us.
        “He was the most prodigious personification of all human inferiorities. He was an utterly incapable, unadapted, irresponsible, psychopathic personality, full of empty, infantile fantasies, but cursed with the keen intuition of a rat or a guttersnipe. He represented the shadow, the inferior part of everybody’s personality, in an overwhelming degree, and this was another reason why they fell for him.”

        Comment


        • I wonder if another Sec of Defense is going to follow him out the door?

          Comment


          • Originally posted by tbm3fan View Post
            I wonder if another Sec of Defense is going to follow him out the door?
            I wouldn't bet against it.

            Only time will tell, but I think Trump is finally, fatally, melting down. He's up against too much right now.

            Even a healthy, functioning human being, in control of their mental faculties, who genuinely cared about this country and its citizens, and surrounded by serious, experienced advistors would be hard-pressed at a time like this.

            Donald Trump is none of those things.
            “He was the most prodigious personification of all human inferiorities. He was an utterly incapable, unadapted, irresponsible, psychopathic personality, full of empty, infantile fantasies, but cursed with the keen intuition of a rat or a guttersnipe. He represented the shadow, the inferior part of everybody’s personality, in an overwhelming degree, and this was another reason why they fell for him.”

            Comment


            • Here in Virginia the two hardest hit areas (Metro Richmond & Northern Virginia) the county & city public health administrations are ALL reporting increases in cases continue to grow daily...some by the hundreds (Fairfax & Prince William).
              “Loyalty to country ALWAYS. Loyalty to government, when it deserves it.”
              Mark Twain

              Comment


              • I see we are coming up on our death toll from the 1957 pandemic around H2N2 of 116,000 deaths. Back then the quite equivalent of Dr. Fauci was Dr. Maurice Hilleman.

                For those who never heard:https://www.merck.com/about/featured...l#chapterEight

                Comment


                • Its all about how it looks on TV

                  https://www.businessinsider.com/whit...tancing-2020-6

                  After months of reporters sitting farther apart and resorting to a rotation to limit capacity at press conferences, the White House moved the press corps' seats closer together in the Rose Garden today.
                  "It looks better," according to the president of the White House Correspondents' Association.

                  "The chairs were initially positioned in a way that was consistent with social distancing guidelines but were moved closer together by White House staff shortly before the event started," Jon Karl, president of the WHCA and the chief White House correspondent for ABC News, wrote in a statement.

                  "The health of the press corps should not be put in jeopardy because the White House wants reporters to be a prop."

                  President Trump has previously riffed about the spaced out seating in both the briefing room and outdoors, and did not formally answer any questions at the Rose Garden press conference.

                  Comment


                  • Code Red? Arizona hospitals could run out of beds by July, public health expert says

                    PHOENIX — Arizona’s coronavirus surge over the last several weeks is raising new concerns about state hospitals’ ability to care for a rising number of patients.

                    The state's flashing indicators are getting national attention.

                    New York Gov. Andrew Cuomo pointed at Arizona Monday as a state that reopened early and is now paying a price.

                    “If we continue for the next several weeks like we have the past few, it’s very possible that we’ll run out of capacity in our hospitals and ICUs sometime in early July,” said Joe Gerald, program director for public health policy and management at the University of Arizona’s Zuckerman College of Public Health.

                    RELATED: 100 days after first confirmed coronavirus case, reopening to test New York

                    Since Gov. Doug Ducey’s stay-at-home order expired May 15, positive coronavirus cases have soared 110% - more than doubling to 27,678, as of Monday.

                    Ducey said last week he didn’t see a trend in the rising number of cases. He said cases were climbing because the state was doing more testing.

                    “The pace of the (COVID-19) spread is accelerating,” said Gerald, who has collaborated in the past on COVID modeling with Arizona State University researchers.

                    “Arizona reacted early, so we never had a rapid growth in cases. That’s the good news … (but) since mid- to late April, Arizonans have kind of developed quarantine fatigue and have been out and about more.”

                    Eight of every 10 hospital beds statewide are in use, according to the state Department of Health Services.

                    About one in every four inpatient beds are used by coronavirus patients; in the ICUs, about one in every three beds are for COVID care.

                    The surge in positive cases and hospitalizations confirms projections by an Arizona State University research team almost four weeks ago.

                    A top aide to Health Services Director Dr. Cara Christ told 12 News the three-page letter was a response to “anecdotal reports” of capacity concerns at hospitals.

                    The key message: Hospitals might have to curtail or stop elective surgeries if they can’t meet the state’s capacity requirements.

                    Elective surgeries are a lucrative business for hospitals. They’ve boomed since Gov. Doug Ducey lifted his ban on the procedures on May 1.

                    The governor kept in place criteria hospitals had to meet to perform the surgeries.

                    Jessica Rigler, assistant director for public health preparedness, said the letter “reminds facilities of the expectations.”

                    “If you’re not meeting criteria, it’s time to review what’s going on with beds to determine if you’re in compliance … You might have to suspend some or all (elective surgeries) to meet bed availability.”

                    “I am concerned that it might happen and we need to do some things to stop that from occurring,” said Dr. Marjorie Bessel, Banner Health’s chief clinical officer.

                    Banner cares for about half of all COVID patients in Arizona hospitals.

                    “It should be a red flag - a warning signal we take seriously,” Gerald said. “Given the scope of care they provide, it makes me very nervous.”

                    A Banner spokeswoman said the company had activated its emergency plan three months ago.

                    Christ said in an interview Monday that DHS was “surprised” by Banner’s warning it was running out of beds.

                    “We were surprised because that’s not what our state data was showing,” she said. “Our data shows we’ve got bed availability in ICUs. We’ll be working with Banner on that.”

                    Banner’s Bessel said the hospital network might have to cut back on surgeries to leave open more beds for COVID patients.
                    _______________
                    “He was the most prodigious personification of all human inferiorities. He was an utterly incapable, unadapted, irresponsible, psychopathic personality, full of empty, infantile fantasies, but cursed with the keen intuition of a rat or a guttersnipe. He represented the shadow, the inferior part of everybody’s personality, in an overwhelming degree, and this was another reason why they fell for him.”

                    Comment


                    • Originally posted by tbm3fan View Post
                      I see we are coming up on our death toll from the 1957 pandemic around H2N2 of 116,000 deaths. Back then the quite equivalent of Dr. Fauci was Dr. Maurice Hilleman.

                      For those who never heard:https://www.merck.com/about/featured...l#chapterEight
                      Don't forget 1968 Hong Kong Flu estimated 1 to 4 million dead world wide. 100,000 US deaths

                      Comment


                      • From TIME Magazine

                        Currently the US has 25 of 50 states on the rise (4 in continuous rise and 21 in a resuming raise after dropping off). 26 (25 + DC) on the decline.

                        Interesting social experiment on releasing too early.


                        https://time.com/5852913/covid-second-wave/
                        “Loyalty to country ALWAYS. Loyalty to government, when it deserves it.”
                        Mark Twain

                        Comment


                        • Originally posted by Albany Rifles View Post
                          From TIME Magazine

                          Currently the US has 25 of 50 states on the rise (4 in continuous rise and 21 in a resuming raise after dropping off). 26 (25 + DC) on the decline.

                          Interesting social experiment on releasing too early.


                          https://time.com/5852913/covid-second-wave/
                          Today on Fox News Larry Kudlow, National Economic Council, called them relatively small bumps which is bigger than a mole hill I guess.

                          Comment


                          • Originally posted by Albany Rifles View Post
                            From TIME Magazine

                            Currently the US has 25 of 50 states on the rise (4 in continuous rise and 21 in a resuming raise after dropping off). 26 (25 + DC) on the decline.

                            Interesting social experiment on releasing too early.


                            https://time.com/5852913/covid-second-wave/
                            Looking at daily cases does not say much. Why are they going up or down. Nobody knows.

                            Much better is to look at positivity rates.

                            https://coronavirus.jhu.edu/testing/testing-positivity

                            35 states under 5% which is good news, if they can reduce those figures further over time they are controlling the disease.

                            NY with a positivity rate of 1.2% NJ at 1.98% is just unbelivable from where they were in April....Michigan at 1.24%, look at their graphs in the TIME article. All the way down.

                            Florida is at 6% which is an improvement since the last time i looked at that states data. Varied between 7 - 15%

                            However, earlier success story California is a borderline case here at 4.56%. Surprised to see that, i'd have expected them to have dipped under 1% by June. Given how strict they were.

                            17 states above 5% not so good news, these states will see a spurt in cases. Much more testing required.

                            South Carolina, Mississipi, Arizona & Alabama are in for a bumpy ride this month. All above 10%

                            Complicating factor here is the states that border those four as you don't prevent people crossing state lines.

                            What is better still is to see a graph of positivty for each state over a period of time. Table like i postd here does not indicate trends.

                            Graph goes up, problems, down improvements. Easy. And it takes a lot of cases to push that graph up.

                            I cannot find such a list of 50 graphs for states of the US : (

                            Another parameter i don't see often is active cases. That's confirmed - recovered and will be smaller than total confirmed.

                            You turn the corner when recovered overtakes active cases and remains that way.
                            Last edited by Double Edge; 16 Jun 20,, 03:23.

                            Comment


                            • Cuomo Reminds New Yorkers (And Cops) Masks Are Not Chin Guards | Gothamist | Jun 13 2020

                              hehe, my city council put up a similar warning a few days ago.

                              People are getting fed up of masks.

                              Comment


                              • What you want is a graph like this showing the 7 day moving average of percent positivity (orange) for all states, aggregated in one place, updated on a regular basis

                                Virigina is improving and is where FL was two weeks ago.

                                Click image for larger version

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                                A moving average plot is more sensitive than one that shows cummulative positivity.

                                Will be easier to see the effect of policy within a couple of weeks.

                                If the % is high there will be more cases otherwise less.

                                Positivity is a better indicator of progress or lack thereof than just looking at number of daily cases which lacks context.
                                Last edited by Double Edge; 17 Jun 20,, 22:18.

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