The Call to "Shut It Down, Start Over, Do It Right"

The Call to "Shut It Down, Start Over, Do It Right" - Printable Version

+- The CardBoard (https://thecardboard.org/board)
+-- Forum: Emergency (https://thecardboard.org/board/forum-11.html)
+--- Forum: Covid-19 (https://thecardboard.org/board/forum-12.html)
+--- Thread: The Call to "Shut It Down, Start Over, Do It Right" (/thread-20141.html)

Pages: 1 2

The Call to "Shut It Down, Start Over, Do It Right" - chrisk - 07-24-2020

A group of health professionals (currently over 150) have proposed this approach in an open letter to "America's decision makers." Zeke Emanuel is at the top of the list. The other names are not as recognizable to the public.

https://uspirg.org/resources/usp/shut-it-down-start-over-do-it-right

"Non-essential businesses should be closed. Restaurant service should be limited to take-out. People should stay home, going out only to get food and medicine or to exercise and get fresh air. Masks should be mandatory in all situations, indoors and outdoors, where we interact with others."

Politicians are not ready to take this step yet.

RE: The Call to "Shut It Down, Start Over, Do It Right" - Snorlax94 - 07-24-2020

This is what I have been saying we should do. And by prioritizing kids going to school, the first thing we should re-open are the schools, and we shouldn’t open anything else until we’ve stabilized numbers with schools open.

Normally I’d say we could keep park rec equipment open, but I have seen so much abuse at parks.

Soccer companies running camps with close to a hundred kids, dozens of people gathering for racquetball tournaments (with fans!)

RE: The Call to "Shut It Down, Start Over, Do It Right" - Genuine Realist - 07-24-2020

https://www.commentarymagazine.com/vivian-bercovici/panic-and-paranoia/

(07-24-2020, 12:42 PM)Snorlax94 Wrote: This is what I have been saying we should do. And by prioritizing kids going to school, the first thing we should re-open are the schools, and we shouldn’t open anything else until we’ve stabilized numbers with schools open.

Normally I’d say we could keep park rec equipment open, but I have seen so much abuse at parks.

Soccer companies running camps with close to a hundred kids, dozens of people gathering for racquetball tournaments (with fans!)

Ain't gonna happen. So it is more a sermon than a proposal.

It's too early to write history, but at least some physicians see the SIP as massive overkill, which has made the public cynical about less drastic responses, such as masking. I don't blame anyone for this, as the virus came on too strong and suddenly for the sort of measured response one would hope for if there were more time for subtlety.

BTW, Israel, which seemed to have the matter well in hand, is about to blow up politically. The dynamic is almost exactly the same as the US.
(The physician I mentioned who characterized the shutdown as medieval is quoted therein/)

Again, it's too early to form conclusions, but I do believe those nations with a large number of small businesses - i.e., persons outside large pools of capital - were able to enforce social austerity far more easily than more diverse (sic) nations. Normally, we would consider that a strength rather than a weakness, but these are unusual times.

RE: The Call to "Shut It Down, Start Over, Do It Right" - OutsiderFan - 07-24-2020

We have three possible strategies:

1. Vaccine
2. Massive testing, contact tracing, infection tracking apps, isolation of known infections
3. Shutdown everything non-essential as a whole country in unison until needed bench marks are met

The reason other countries have stopped this is because they acted as a whole country. With different states doing different things, it's just whack-a-mole. If we continue on the same course we are on with individual states doing their own things, it's never going to get under control. Our approach is going to continue causing us problems until we act in a coordinated and comprehensive manner.

RE: The Call to "Shut It Down, Start Over, Do It Right" - chrisk - 07-24-2020

A big problem now is that the testing system is overwhelmed with the resulting delay in reporting results making many of them worthless.

Even if we don’t go to a strict lockdown, steps need to be taken to slow the spread.

Who thought 4 months ago, Americans would make the Italians look good?

RE: The Call to "Shut It Down, Start Over, Do It Right" - 76lsjumb - 07-24-2020

(07-24-2020, 02:30 PM)OutsiderFan Wrote: We have three possible strategies:

1. Vaccine
2. Massive testing, contact tracing, infection tracking apps, isolation of known infections
3. Shutdown everything non-essential as a whole country in unison until needed bench marks are met

The reason other countries have stopped this is because they acted as a whole country. With different states doing different things, it's just whack-a-mole. If we continue on the same course we are on with individual states doing their own things, it's never going to get under control. Our approach is going to continue causing us problems until we act in a coordinated and comprehensive manner.

So you're saying that the coronavirus is sophisticated enough to recognize the border between countries but not the border between states? Or that, if only Montana did the exact same things as Rhode Island, everything would be fine?

Yeah, that makes a lot of sense...

RE: The Call to "Shut It Down, Start Over, Do It Right" - BostonCard - 07-24-2020

Well, there's a fourth option, and it is one that we seem to have pursued. Make general efforts at social distancing, imperfect mask usage, open what we can, but stop opening when things get out of hand, and more or less give up on trying to truly drive the infection under control. We have implicitly decided that as a country we are ok with 500 to 1000 of our countrymen dying every day.

BC

RE: The Call to "Shut It Down, Start Over, Do It Right" - Goose - 07-24-2020

(07-24-2020, 03:25 PM)BostonCard Wrote: Well, there's a fourth option, and it is one that we seem to have pursued. Make general efforts at social distancing, imperfect mask usage, open what we can, but stop opening when things get out of hand, and more or less give up on trying to truly drive the infection under control. We have implicitly decided that as a country we are ok with 500 to 1000 of our countrymen dying every day.

BC

I think you are correct regarding our "strategy". I would modulate it a bit by saying the politicians probably intended to use testing and contact tracing but then realized that would require enforcement. They aren't willing to do that. Ditto for masking. Ditto for social distancing. We ask people to comply and take what we get.

I think the number of our countrymen dying every day is regarded as inevitable no matter what we do by the public at large. That position isn't totally illogical. The idea of staying "shut down" until we have a vaccine isn't economically acceptable to the public. As long as we don't overload our health care system to the point we can't give high quality care to everybody, the COVID-19 deaths are regarded as unavoidable. Those people were going to get COVID-19 eventually anyway, so now is as good a time as any.

The obvious problem with this "strategy" is that as case loads increase the health care system WILL become overloaded and "extra" people will die due to unavailability of care. We need to stay just short of that. How that is actually going to play out is anybodies guess, but it sounds awfully unstable to me. Once you are "over the top" there is no obvious way to pull back. It would require people recognizing the problem and actually doing what they are unwilling to do before the fact. Give me odds.

RE: The Call to "Shut It Down, Start Over, Do It Right" - lex24 - 07-24-2020

(07-24-2020, 04:13 PM)Goose Wrote:
(07-24-2020, 03:25 PM)BostonCard Wrote: Well, there's a fourth option, and it is one that we seem to have pursued. Make general efforts at social distancing, imperfect mask usage, open what we can, but stop opening when things get out of hand, and more or less give up on trying to truly drive the infection under control. We have implicitly decided that as a country we are ok with 500 to 1000 of our countrymen dying every day.

BC
I think you are correct regarding our "strategy". I would modulate it a bit by saying the politicians probably intended to use testing and contact tracing but then realized that would require enforcement. They aren't willing to do that. Ditto for masking. Ditto for social distancing. We ask people to comply and take what we get.

I think the number of our countrymen dying every day is regarded as inevitable no matter what we do by the public at large. That position isn't totally illogical. The idea of staying "shut down" until we have a vaccine isn't economically acceptable to the public. As long as we don't overload our health care system to the point we can't give high quality care to everybody, the COVID-19 deaths are regarded as unavoidable. Those people were going to get COVID-19 eventually anyway, so now is as good a time as any.

The obvious problem with this "strategy" is that as case loads increase the health care system WILL become overloaded and "extra" people will die due to unavailability of care. We need to stay just short of that. How that is actually going to play out is anybodies guess, but it sounds awfully unstable to me. Once you are "over the top" there is no obvious way to pull back. It would require people recognizing the problem and actually doing what they are unwilling to do before the fact. Give me odds.

It’s not just economics. It’s mental health. I saw a report on NPR last night about the heavy increase in opioid overdoses during the pandemic. As explained by a woman who is a former addict who is now involved in outreach to try to save current addicts - a lot of these people are alone and have lost any social contact they have making it that much more likely they dig deeper into opioids. And in what is rather ironic, the flow of drugs from across the border has slowed – which does not mean that what is available for the user has slowed. What it means is the user is less likely to know what he or she gets. Making it more likely that they will suffer an overdose. Suicides and attempts are also way up.

There are no easy answers to any of this. I just don’t think it’s as black and white as some say.
Part of me wonders if another potential strategy is to heavily focus resources into those areas that are the hotspots. And correct me if I’m wrong on this – but most of those hotspots are in densely populated areas with populations that are economically disadvantaged. But you can’t devise a strategy that imposes special shelter in place orders on specific areas within densely populated areas where the pandemic hits the hardest. There are simply too many social factors that go into that that make it impossible.

And if you question what I’m saying take a look at the Eastbay. Compare the 880 corridor to the 680 corridor in terms of the Covid impact on those areas. For those of that are not local, the 680 Corridor is the higher income bracket. They have not been hit anywhere near as badly as those that live in the 880 Corridor. Then check number to look at those towns in the 24 area – Orinda Lafayette Moraga etc. and compare to those towns around Highway four - Pittsburgh Antioch San Pablo. Same difference economically. Same difference relating to Covid.

Please do not misconstrue what I’m saying. I’m not positing “blame” on those people who live in poor economic areas. Far from it. But it is logical quite frankly that the outbreaks would be heavier there. Population density is higher and I suspect there are a whole lot more people that have to leave their houses to work so they can make enough to put food on their table. It’s much easier to shelter in place if you have the economic wherewithal to do so. And then there is the Health differences - and the difference in health care access.

I admit I may be wrong on this and am misconstruing data that is not indicative of the spread of the disease across the country. But if we are truly to look at all aspects of this, I would think this would be important to look at.

RE: The Call to "Shut It Down, Start Over, Do It Right" - BostonCard - 07-24-2020

(07-24-2020, 04:24 PM)lex24 Wrote: A question Outsider Fan- under what Constitutional authority may a President order a nationwide shutdown? Congress might – although I think it’s dubious - be within its constitutional power to pass legislation mandating all 50 states to shut down. Although the trigger under which Congress usually passes laws is the commerce clause. And that would be an interesting use of the clause as it would essentially shut down commerce. But I see nothing that gives the president such authority. With the possible exception of declaring martial law. And I don’t think that would go over too well.

Would the National Emergencies Act give him that authority? Maybe the Public Health Act (section on public health emergencies).

That being said, I would not want a president to declare a national emergency and impose a nationwide shutdown. Like if we say that the Nationwide Emergencies Act would give authority to order a nationwide shutdown for this, what would prevent him from imposing a curfew to stop Black Lives Matter protests (or a Democrat stopping a Gun rights protest or pro-life rally)? Would be much better if Congress appropriated funds to support states that go into lockdown.

Of course, there is a lot the President can do without issuing an executive order or equivalent. A consistent message would help. A clearly defined guidance would place the onus on state and local leaders who don't follow the guidelines as to why not.

But I think I agree with you that you probably want to tailor your guidance to local conditions. We shouldn't pursue a lowest common denominator strategy.

BC

RE: The Call to "Shut It Down, Start Over, Do It Right" - lex24 - 07-24-2020

(07-24-2020, 05:04 PM)BostonCard Wrote:
(07-24-2020, 04:24 PM)lex24 Wrote: A question Outsider Fan- under what Constitutional authority may a President order a nationwide shutdown? Congress might – although I think it’s dubious - be within its constitutional power to pass legislation mandating all 50 states to shut down. Although the trigger under which Congress usually passes laws is the commerce clause. And that would be an interesting use of the clause as it would essentially shut down commerce. But I see nothing that gives the president such authority. With the possible exception of declaring martial law. And I don’t think that would go over too well.

Would the National Emergencies Act give him that authority? Maybe the Public Health Act (section on public health emergencies).

That being said, I would not want a president to declare a national emergency and impose a nationwide shutdown. Like if we say that the Nationwide Emergencies Act would give authority to order a nationwide shutdown for this, what would prevent him from imposing a curfew to stop Black Lives Matter protests (or a Democrat stopping a Gun rights protest or pro-life rally)? Would be much better if Congress appropriated funds to support states that go into lockdown.

Of course, there is a lot the President can do without issuing an executive order or equivalent. A consistent message would help. A clearly defined guidance would place the onus on state and local leaders who don't follow the guidelines as to why not.

But I think I agree with you that you probably want to tailor your guidance to local conditions. We shouldn't pursue a lowest common denominator strategy.

BC

National Emergency Act was enacted to make it easier for Congress to END a declared national emergency.

The Feds could pass restrictions relating to Federal Property etc. But to shut down states- and it is states that have the primary police powers- I don’t think so.

And remember, when Trump said he had the power to order states to reopen, he was swiftly (and appropriately) told otherwise.

RE: The Call to "Shut It Down, Start Over, Do It Right" - chrisk - 07-24-2020

More states are imposing quarantines on travelers from other states. What are the limits of that authority? Can they lock people up for 2 weeks but not prevent them from coming in to the state? What are the limits on enforcing the quarantine? Electronic bracelet? Hotel room checks? No key to the hotel room but supply food?

RE: The Call to "Shut It Down, Start Over, Do It Right" - lex24 - 07-24-2020

(07-24-2020, 05:41 PM)chrisk Wrote: More states are imposing quarantines on travelers from other states. What are the limits of that authority? Can they lock people up for 2 weeks but not prevent them from coming in to the state? What are the limits on enforcing the quarantine? Electronic bracelet? Hotel room checks? No key to the hotel room but supply food?

I think the states authority to impose such restrictions are iquestionable, at best. Not sure if anyone has filed suit. Edit: Here is an article from the Hill written b6 an attorney from the Pacific Legal Foundation. Note: PLF is a conservative group.
https://thehill.com/opinion/judiciary/507142-quarantines-for-out-of-state-visitors-exceeds-governors-emergency-authority

RE: The Call to "Shut It Down, Start Over, Do It Right" - BostonCard - 07-24-2020

(07-24-2020, 04:55 PM)lex24 Wrote: There are no easy answers to any of this. I just don’t think it’s as black and white as some say.
Part of me wonders if another potential strategy is to heavily focus resources into those areas that are the hotspots. And correct me if I’m wrong on this – but most of those hotspots are in densely populated areas with populations that are economically disadvantaged. But you can’t devise a strategy that imposes special shelter in place orders on specific areas within densely populated areas where the pandemic hits the hardest. There are simply too many social factors that go into that that make it impossible.

And if you question what I’m saying take a look at the Eastbay. Compare the 880 corridor to the 680 corridor in terms of the Covid impact on those areas. For those of that are not local, the 680 Corridor is the higher income bracket. They have not been hit anywhere near as badly as those that live in the 880 Corridor. Then check number to look at those towns in the 24 area – Orinda Lafayette Moraga etc. and compare to those towns around Highway four - Pittsburgh Antioch San Pablo. Same difference economically. Same difference relating to Covid.

Please do not misconstrue what I’m saying. I’m not positing “blame” on those people who live in poor economic areas. Far from it. But it is logical quite frankly that the outbreaks would be heavier there. Population density is higher and I suspect there are a whole lot more people that have to leave their houses to work so they can make enough to put food on their table. It’s much easier to shelter in place if you have the economic wherewithal to do so. And then there is the Health differences - and the difference in health care access.

I admit I may be wrong on this and am misconstruing data that is not indicative of the spread of the disease across the country. But if we are truly to look at all aspects of this, I would think this would be important to look at.

This article came to a similar conclusion: https://jamanetwork.com/journals/jama/fullarticle/2767631?guestAccessKey=9033c59a-7289-44c7-bec4-01f55be3d1b0&utm_source=silverchair&utm_campaign=jama_network&utm_content=covid_weekly_highlights&utm_medium=email

Quote:We identified 434 New York City residents who were tested for SARS-CoV-2. Of the 396 patients (91%) linked to buildings and neighborhoods in the city, 71 (17.9%) were infected with SARS-CoV-2. Cohort characteristics are tabulated in the Table. The likelihood of SARS-CoV-2 varied substantially across measures of built environment and neighborhood socioeconomic status (Figure). The lowest probability of infection was estimated for women living in buildings with very high assessed values (8.2% [95% CI, 1.2%-15.2%]) and the highest was for those residing in neighborhoods with high household membership (23.9% [95% CI, 18.4%-29.4%]). Odds of infection were lower among women living in buildings with more residential units (interdecile OR, 0.34 [95% CI, 0.16-0.72]) and higher assessed values (interdecile OR, 0.29 [95% CI, 0.10-0.89]) and in neighborhoods with higher median incomes (interdecile OR, 0.32 [95% CI, 0.12-0.83]). Odds of infection were higher among women residing in neighborhoods with high unemployment rates (interdecile OR, 2.13 [95 CI, 1.18-3.83]), large household membership (interdecile OR, 3.16 [95% CI, 1.58-6.37]), and greater household crowding (interdecile OR, 2.27 [95% CI, 1.12-4.61]). There was no statistically significant association between SARS-CoV-2 infection and population density (interdecile OR, 0.70 [95% CI, 0.32-1.51]) or poverty rate (interdecile OR, 2.03 [95% CI, 0.97-4.25]). Neighborhood-level variables were moderately to highly correlated (|r|, 0.66-0.83).

In this study, SARS-CoV-2 transmission among pregnant women in New York City was associated with neighborhood- and building-level markers of large household membership, household crowding, and low socioeconomic status.

And I am not misconstruing your point, which is that poverty and a lot of the factors that go along with it, is a risk factor for getting COVID-19. I know you aren't blaming people for being poor.

BC

RE: The Call to "Shut It Down, Start Over, Do It Right" - oldalum - 07-24-2020

I think the concern motivating calls for simultaneous nationwide SiP is the problem of travel between states/areas of high and low infection. I don't know how big a problem that really is. I don't know if the states can legally limit that travel, but I think the federal government can.

lex24 - lex24 - 07-24-2020

(07-24-2020, 07:30 PM)oldalum Wrote: I think the concern motivating calls for simultaneous nationwide SiP is the problem of travel between states/areas of high and low infection. I don't know how big a problem that really is. I don't know if the states can legally limit that travel, but I think the federal government can.

Actually it’s not likely the Feds can. The USSC has held there is a Constitutional right to travel.

RE: lex24 - Goose - 07-24-2020

(07-24-2020, 08:40 PM)lex24 Wrote:
(07-24-2020, 07:30 PM)oldalum Wrote: I think the concern motivating calls for simultaneous nationwide SiP is the problem of travel between states/areas of high and low infection. I don't know how big a problem that really is. I don't know if the states can legally limit that travel, but I think the federal government can.

Actually it’s not likely the Feds can. The USSC has held there is a Constitutional right to travel.

I think they can. The Feds have the ability to regulate interstate commerce. The States may not restrict interstate commerce without good reason, and must do so in a way that allows for due process, such as a hearing before someone can be prevented from entering the state. The Feds have no such requirement. I believe the Feds can regulate passage from one state to another to enforce the "national quarantine". The USPHS has been explicitly delegated the power to do so.

RE: The Call to "Shut It Down, Start Over, Do It Right" - BostonCard - 07-24-2020

The CDC agrees with Goose:

https://www.cdc.gov/quarantine/aboutlawsregulationsquarantineisolation.html

Quote:Federal Law
The federal government derives its authority for isolation and quarantine from the Commerce Clause of the U.S. Constitution.

Under section 361 of the Public Health Service Act (42 U.S. Code § 264), the U.S. Secretary of Health and Human Services is authorized to take measures to prevent the entry and spread of communicable diseases from foreign countries into the United States and between states.

The authority for carrying out these functions on a daily basis has been delegated to the Centers for Disease Control and Prevention (CDC).

(emphasis mine)

Here is the relevant code:

https://www.law.cornell.edu/uscode/text/42/264

BC

lex24 - lex24 - 07-24-2020

(07-24-2020, 08:55 PM)Goose Wrote:
(07-24-2020, 08:40 PM)lex24 Wrote:
(07-24-2020, 07:30 PM)oldalum Wrote: I think the concern motivating calls for simultaneous nationwide SiP is the problem of travel between states/areas of high and low infection. I don't know how big a problem that really is. I don't know if the states can legally limit that travel, but I think the federal government can.

Actually it’s not likely the Feds can. The USSC has held there is a Constitutional right to travel.
I think they can. The Feds have the ability to regulate interstate commerce. The States may not restrict interstate commerce without good reason, and must do so in a way that allows for due process, such as a hearing before someone can be prevented from entering the state. The Feds have no such requirement. I believe the Feds can regulate passage from one state to another to enforce the "national quarantine". The USPHS has been explicitly delegated the power to do so.

(07-24-2020, 09:49 PM)lex24 Wrote:
(07-24-2020, 08:55 PM)Goose Wrote:
(07-24-2020, 08:40 PM)lex24 Wrote:
(07-24-2020, 07:30 PM)oldalum Wrote: I think the concern motivating calls for simultaneous nationwide SiP is the problem of travel between states/areas of high and low infection. I don't know how big a problem that really is. I don't know if the states can legally limit that travel, but I think the federal government can.

Actually it’s not likely the Feds can. The USSC has held there is a Constitutional right to travel.
I think they can. The Feds have the ability to regulate interstate commerce. The States may not restrict interstate commerce without good reason, and must do so in a way that allows for due process, such as a hearing before someone can be prevented from entering the state. The Feds have no such requirement. I believe the Feds can regulate passage from one state to another to enforce the "national quarantine". The USPHS has been explicitly delegated the power to do so.

Certainly the feds can put provisions in place to quarantine and restrict travel by those people who are known to be infected. But to put a blanket order that indicates that no one may travel between states is a completely different matter. And I have a hard time believing that would pass constitutional muster in that it would be too broad of a restriction of the right to travel. But we will never know because it’s not gonna happen

RE: lex24 - akiddoc - 07-25-2020

(07-24-2020, 09:49 PM)lex24 Wrote:
(07-24-2020, 08:55 PM)Goose Wrote:
(07-24-2020, 08:40 PM)lex24 Wrote:
(07-24-2020, 07:30 PM)oldalum Wrote: I think the concern motivating calls for simultaneous nationwide SiP is the problem of travel between states/areas of high and low infection. I don't know how big a problem that really is. I don't know if the states can legally limit that travel, but I think the federal government can.

Actually it’s not likely the Feds can. The USSC has held there is a Constitutional right to travel.
I think they can. The Feds have the ability to regulate interstate commerce. The States may not restrict interstate commerce without good reason, and must do so in a way that allows for due process, such as a hearing before someone can be prevented from entering the state. The Feds have no such requirement. I believe the Feds can regulate passage from one state to another to enforce the "national quarantine". The USPHS has been explicitly delegated the power to do so.

(07-24-2020, 09:49 PM)lex24 Wrote:
(07-24-2020, 08:55 PM)Goose Wrote:
(07-24-2020, 08:40 PM)lex24 Wrote:
(07-24-2020, 07:30 PM)oldalum Wrote: I think the concern motivating calls for simultaneous nationwide SiP is the problem of travel between states/areas of high and low infection. I don't know how big a problem that really is. I don't know if the states can legally limit that travel, but I think the federal government can.

Actually it’s not likely the Feds can. The USSC has held there is a Constitutional right to travel.
I think they can. The Feds have the ability to regulate interstate commerce. The States may not restrict interstate commerce without good reason, and must do so in a way that allows for due process, such as a hearing before someone can be prevented from entering the state. The Feds have no such requirement. I believe the Feds can regulate passage from one state to another to enforce the "national quarantine". The USPHS has been explicitly delegated the power to do so.

Certainly the feds can put provisions in place to quarantine and restrict travel by those people who are known to be infected. But to put a blanket order that indicates that no one may travel between states is a completely different matter. And I have a hard time believing that would pass constitutional muster in that it would be too broad of a restriction of the right to travel. But we will never know because it’s not gonna happen

If this virus was killing 30% of those who caught it, I don't think we would be worrying about the details of what the USSC has ruled. And we're damn lucky it wasn't one of "those" Coronaviruses.

In order to deal with future pandemics, there needs to be an adjustment in how the country reacts, or we'll go from first world country to third in a span of 2 or 3 years.