[lex24]

One of the things that galls me about the orders (especially at the County level) are the lack of questions being asked.   All we get is generalities.  Which tells us very little.

Questions that I think we deserve answers to:

1.  Who are the people being hospitalized? Demographics- age, gender, comorbidities (or lack thereof) socioeconomic status.  In real numbers.  Historically and this last month. 

2. Same questions as to those that are dying.

3. Curfew-  Given restaurants, bars and essentially all other forms of entertainment are shut down - what is the scientific/medical/statistical evidence behind this move. And I mean specifics.  In other words - is there evidence that activities after 10 have disproportionately added to the spread?  To hospitalizations?  To deaths?

4. SCC 150 mile rule.  What evidence is there that increased rates are as the result of people coming into the County from outside this 150 zone? Including hospitization rates and death rates.

5. SCC. Contact sports rule and professional and collegiate sports. Same questions.  (BTW- how many College or Pro Bay Area athletes(or those that work at the facilities - coaches, etc) have landed in the hospital or died of Covid.). Is there evidence that these athletes (or those around the team) have infected others at a high rate?

I understand BC’s “ballast” argument.  But I don’t agree with it.  Because all these moves have consequences upon people that go beyond the virus.  Economically for some.  Kids and education. Mental health for some. 

When this hit in March, people for the most part were willing to SIP under the assumption that it would be short term. 9 months in, fatigue sets in.  Understandably. With severe consequences.

I think we have a right to know the specifics. Without them, I think the public is not served. And I think the result is more and more will tune out. (Beyond the basics of masks, social distancing, avoiding large gatherings, washing hands.)

[lex24]

One of the things that galls me about the orders (especially at the County level) are the lack of questions being asked.   All we get is generalities.  Which tells us very little.

Questions that I think we deserve answers to:

1.  Who are the people being hospitalized? Demographics- age, gender, comorbidities (or lack thereof) socioeconomic status.  In real numbers.  Historically and this last month. 

2. Same questions as to those that are dying.

3. Curfew-  Given restaurants, bars and essentially all other forms of entertainment are shut down - what is the scientific/medical/statistical evidence behind this move. And I mean specifics.  In other words - is there evidence that activities after 10 have disproportionately added to the spread?  To hospitalizations?  To deaths?

4. SCC 150 mile rule.  What evidence is there that increased rates are as the result of people coming into the County from outside this 150 zone? Including hospitization rates and death rates.

5. SCC. Contact sports rule and professional and collegiate sports. Same questions.  (BTW- how many College or Pro Bay Area athletes(or those that work at the facilities - coaches, etc) have landed in the hospital or died of Covid.). Is there evidence that these athletes (or those around the team) have infected others at a high rate?

I understand BC’s “ballast” argument.  But I don’t agree with it.  Because all these moves have consequences upon people that go beyond the virus.  Economically for some.  Kids and education. Mental health for some. 

When this hit in March, people for the most part were willing to SIP under the assumption that it would be short term. 9 months in, fatigue sets in.  Understandably. With severe consequences.

I think we have a right to know the specifics. Without them, I think the public is not served. And I think the result is more and more will tune out. (Beyond the basics of masks, social distancing, avoiding large gatherings, washing hands.)

[Goose]

When this hit in March, people for the most part were willing to SIP under the assumption that it would be short term. 9 months in, fatigue sets in.  Understandably. With severe consequences.


I think we have a right to know the specifics.  Without them, I think the public is not served. And I think the result is more and more will tune out.  (Beyond the basics of masks, social distancing, avoiding large gatherings, washing hands.)

Lex24, I don't think they know the specifics. I really don't think anybody has been looking, or if they have, they haven't found anything. I think that is true here and in Europe. The only thing we know for sure is that we can bring the case load down to acceptable by an SIP, but no Western nation has really managed to keep it there after lifting restrictions. Korea, NZ,Taiwan etc basically drove cases down to zero (or more correctly never had them rise to massive community spread), and by careful management have kept COVID-19 under control. We didn't do that, Europe didn't do that. We all have theories about what we should do now, but the fact is nobody knows what balance of regulations will drive Reff down to below 1.0 and keep it there. We are trying things, as are other jurisdictions. What works today may not work tomorrow. Going to be a rocky six months or so, best case.

[Goose]

When this hit in March, people for the most part were willing to SIP under the assumption that it would be short term. 9 months in, fatigue sets in.  Understandably. With severe consequences.


I think we have a right to know the specifics.  Without them, I think the public is not served. And I think the result is more and more will tune out.  (Beyond the basics of masks, social distancing, avoiding large gatherings, washing hands.)

Lex24, I don't think they know the specifics. I really don't think anybody has been looking, or if they have, they haven't found anything. I think that is true here and in Europe. The only thing we know for sure is that we can bring the case load down to acceptable by an SIP, but no Western nation has really managed to keep it there after lifting restrictions. Korea, NZ,Taiwan etc basically drove cases down to zero (or more correctly never had them rise to massive community spread), and by careful management have kept COVID-19 under control. We didn't do that, Europe didn't do that. We all have theories about what we should do now, but the fact is nobody knows what balance of regulations will drive Reff down to below 1.0 and keep it there. We are trying things, as are other jurisdictions. What works today may not work tomorrow. Going to be a rocky six months or so, best case.

[oldalum]

I suspect that the good quality, fine-grained evidence of effectiveness of specific interventions that we would like to see mostly does not exist. But doing nothing differently is not an option, either, when SCC is experiencing such exponential growth of infections. I suspect (but have no idea) that there is informal networking between our public health officers and those beyond the Bay Area, and there is some exchange of ideas and experiences. There has been some learning and changes over time, such as keeping hair salons and barber shops open when formerly they were closed. I agree that it would be good to know more of the basis for individual actions: some other area's experience, studies, anecdotes, hunches, what was served for breakfast that morning? But it seems to me much of it is necessarily just judgment. Will there ever be evidence that 10% occupancy in indoor gyms is safe but 25% is not?--or more precisely, what the expected rate of new infections is from either limit? Bottom line is that sustained proximity of people to others from a different household is fueling the infection and it has to be restricted in some manner and to some extent, and the line-drawing is difficult. We might think that exempting NCAA athletes from the "pause" is a no-brainer, but I'd bet there are a thousand other such no-brainers in different fields and situations, and they can't deal with that many exceptions. Plus, the carving out of exceptions can serve to loosen the tightness with which others keep to the rules. This is clearly not an easy task, and almost any action can be criticized. 

[oldalum]

I suspect that the good quality, fine-grained evidence of effectiveness of specific interventions that we would like to see mostly does not exist. But doing nothing differently is not an option, either, when SCC is experiencing such exponential growth of infections. I suspect (but have no idea) that there is informal networking between our public health officers and those beyond the Bay Area, and there is some exchange of ideas and experiences. There has been some learning and changes over time, such as keeping hair salons and barber shops open when formerly they were closed. I agree that it would be good to know more of the basis for individual actions: some other area's experience, studies, anecdotes, hunches, what was served for breakfast that morning? But it seems to me much of it is necessarily just judgment. Will there ever be evidence that 10% occupancy in indoor gyms is safe but 25% is not?--or more precisely, what the expected rate of new infections is from either limit? Bottom line is that sustained proximity of people to others from a different household is fueling the infection and it has to be restricted in some manner and to some extent, and the line-drawing is difficult. We might think that exempting NCAA athletes from the "pause" is a no-brainer, but I'd bet there are a thousand other such no-brainers in different fields and situations, and they can't deal with that many exceptions. Plus, the carving out of exceptions can serve to loosen the tightness with which others keep to the rules. This is clearly not an easy task, and almost any action can be criticized. 

[M T]

One of the things that galls me about the orders (especially at the County level) are the lack of questions being asked.   All we get is generalities.  Which tells us very little.
Questions that I think we deserve answers to:
1.  Who are the people being hospitalized? Demographics- age, gender, comorbidities (or lack thereof) socioeconomic status.  In real numbers.  Historically and this last month.
2. Same questions as to those that are dying.
...
I think we have a right to know the specifics.  Without them, I think the public is not served. And I think the result is more and more will tune out.  (Beyond the basics of masks, social distancing, avoiding large gatherings, washing hands.)

Why do you complain that something isn't there when it is?  At least, we have that for the cases and deaths. Is it super important to distinguish hospitalizations?  Essentially every county is providing case & death demographics, the states provide it, and the CDC and others provide it nationally.  I suspect it is available for most countries & the world in total.

When you get down to the level of hospitalization in a county and start subdividing it (for instance, how many also have cancer and are in the ICU), you start getting to the point at which individuals can be associated with characteristics.

If you want to look at hospitalization numbers specifically, here's detail but from March
https://www.cdc.gov/mmwr/volumes/69/wr/mm6915e3.htm
You can look at age & ethnicity year to date here
https://www.cdc.gov/coronavirus/2019-nco...index.html
If you want trends over time for hospitalizations by age, use this
https://gis.cdc.gov/grasp/COVIDNet/COVID19_3.html

[M T]

One of the things that galls me about the orders (especially at the County level) are the lack of questions being asked.   All we get is generalities.  Which tells us very little.
Questions that I think we deserve answers to:
1.  Who are the people being hospitalized? Demographics- age, gender, comorbidities (or lack thereof) socioeconomic status.  In real numbers.  Historically and this last month.
2. Same questions as to those that are dying.
...
I think we have a right to know the specifics.  Without them, I think the public is not served. And I think the result is more and more will tune out.  (Beyond the basics of masks, social distancing, avoiding large gatherings, washing hands.)

Why do you complain that something isn't there when it is?  At least, we have that for the cases and deaths. Is it super important to distinguish hospitalizations?  Essentially every county is providing case & death demographics, the states provide it, and the CDC and others provide it nationally.  I suspect it is available for most countries & the world in total.

When you get down to the level of hospitalization in a county and start subdividing it (for instance, how many also have cancer and are in the ICU), you start getting to the point at which individuals can be associated with characteristics.

If you want to look at hospitalization numbers specifically, here's detail but from March
https://www.cdc.gov/mmwr/volumes/69/wr/mm6915e3.htm
You can look at age & ethnicity year to date here
https://www.cdc.gov/coronavirus/2019-nco...index.html
If you want trends over time for hospitalizations by age, use this
https://gis.cdc.gov/grasp/COVIDNet/COVID19_3.html

[teejers1]

One of the things that galls me about the orders (especially at the County level) are the lack of questions being asked.   All we get is generalities.  Which tells us very little.

Questions that I think we deserve answers to:

1.  Who are the people being hospitalized? Demographics- age, gender, comorbidities (or lack thereof) socioeconomic status.  In real numbers.  Historically and this last month. 

2. Same questions as to those that are dying.

3. Curfew-  Given restaurants, bars and essentially all other forms of entertainment are shut down - what is the scientific/medical/statistical evidence behind this move. And I mean specifics.  In other words - is there evidence that activities after 10 have disproportionately added to the spread?  To hospitalizations?  To deaths?

4. SCC 150 mile rule.  What evidence is there that increased rates are as the result of people coming into the County from outside this 150 zone?  Including hospitization rates and death rates.

5. SCC. Contact sports rule and professional and collegiate sports. Same questions.  (BTW- how many College or Pro Bay Area athletes(or those that work at the facilities - coaches, etc) have landed in the hospital or died of Covid.). Is there evidence that these athletes (or those around the team) have infected others at a high rate? 

I understand BC’s “ballast” argument.  But I don’t agree with it.  Because all these moves have consequences upon people that go beyond  the virus.  Economically for some.  Kids and education.  Mental health for some. 

When this hit in March, people for the most part were willing to SIP under the assumption that it would be short term. 9 months in, fatigue sets in.  Understandably. With severe consequences.

I think we have a right to know the specifics.  Without them, I think the public is not served. And I think the result is more and more will tune out.  (Beyond the basics of masks, social distancing, avoiding large gatherings, washing hands.)

One other data point I assume is available - but haven't seen published (barring an estimate many months ago):  the number of patients who contract Covid at the hospital.  Presumably this number is small - but it's not zero.  Indeed, my Donner roommate's mom went into a hospital for hip surgery and contracted Covid there.  Needless to say, that's not good.

[teejers1]

One of the things that galls me about the orders (especially at the County level) are the lack of questions being asked.   All we get is generalities.  Which tells us very little.

Questions that I think we deserve answers to:

1.  Who are the people being hospitalized? Demographics- age, gender, comorbidities (or lack thereof) socioeconomic status.  In real numbers.  Historically and this last month. 

2. Same questions as to those that are dying.

3. Curfew-  Given restaurants, bars and essentially all other forms of entertainment are shut down - what is the scientific/medical/statistical evidence behind this move. And I mean specifics.  In other words - is there evidence that activities after 10 have disproportionately added to the spread?  To hospitalizations?  To deaths?

4. SCC 150 mile rule.  What evidence is there that increased rates are as the result of people coming into the County from outside this 150 zone?  Including hospitization rates and death rates.

5. SCC. Contact sports rule and professional and collegiate sports. Same questions.  (BTW- how many College or Pro Bay Area athletes(or those that work at the facilities - coaches, etc) have landed in the hospital or died of Covid.). Is there evidence that these athletes (or those around the team) have infected others at a high rate? 

I understand BC’s “ballast” argument.  But I don’t agree with it.  Because all these moves have consequences upon people that go beyond  the virus.  Economically for some.  Kids and education.  Mental health for some. 

When this hit in March, people for the most part were willing to SIP under the assumption that it would be short term. 9 months in, fatigue sets in.  Understandably. With severe consequences.

I think we have a right to know the specifics.  Without them, I think the public is not served. And I think the result is more and more will tune out.  (Beyond the basics of masks, social distancing, avoiding large gatherings, washing hands.)

One other data point I assume is available - but haven't seen published (barring an estimate many months ago):  the number of patients who contract Covid at the hospital.  Presumably this number is small - but it's not zero.  Indeed, my Donner roommate's mom went into a hospital for hip surgery and contracted Covid there.  Needless to say, that's not good.

[M T]

One other data point I assume is available - but haven't seen published (barring an estimate many months ago):  the number of patients who contract Covid at the hospital.  Presumably this number is small - but it's not zero.  Indeed, my Donner roommate's mom went into a hospital for hip surgery and contracted Covid there.  Needless to say, that's not good.

On Sep 16, the WSJ indicated an average of 120 cases a day of COVID were acquired in US hospitals (according to unpublished federal data).
The BBC just published something about cases acquired in the hospital in Scotland.

Essentially 100% of the patient cases of COVID-19 in Long Term Care Facilities are caught there.  As I understand it, families are not allowed at the facilities.   (I don't like the numbers I see at SCC right now. 14 facilities have had patient cases in last 14 days.  12 of those facilities claim no staff cases have been found in the last 14 days.  3 of those 12 claim no staff cases in the last 28 days.)


I have a brother-in-law in the hospital right now in a county with something like 3x the new case rate of SCC.  He required hospitalization so there was no choice (he went to ER earlier in the week & they sent him home, but he went downhill).  They want to send him to rehab (for a leg problem) but I am of the opinion that he be sent home unless he requires IV or monitoring available in a rehab facility that isn't available at home. (His mother died of C-Diff acquired in a rehab facility.)      The ER, the hospital, and the rehab facility won't let his spouse be there. 

 (HINT: If someone might go to such a facility, make sure they have a phone they can put on speaker mode while the doctor is in the room, so information is accurately shared with the family.)

[M T]

One other data point I assume is available - but haven't seen published (barring an estimate many months ago):  the number of patients who contract Covid at the hospital.  Presumably this number is small - but it's not zero.  Indeed, my Donner roommate's mom went into a hospital for hip surgery and contracted Covid there.  Needless to say, that's not good.

On Sep 16, the WSJ indicated an average of 120 cases a day of COVID were acquired in US hospitals (according to unpublished federal data).
The BBC just published something about cases acquired in the hospital in Scotland.

Essentially 100% of the patient cases of COVID-19 in Long Term Care Facilities are caught there.  As I understand it, families are not allowed at the facilities.   (I don't like the numbers I see at SCC right now. 14 facilities have had patient cases in last 14 days.  12 of those facilities claim no staff cases have been found in the last 14 days.  3 of those 12 claim no staff cases in the last 28 days.)


I have a brother-in-law in the hospital right now in a county with something like 3x the new case rate of SCC.  He required hospitalization so there was no choice (he went to ER earlier in the week & they sent him home, but he went downhill).  They want to send him to rehab (for a leg problem) but I am of the opinion that he be sent home unless he requires IV or monitoring available in a rehab facility that isn't available at home. (His mother died of C-Diff acquired in a rehab facility.)      The ER, the hospital, and the rehab facility won't let his spouse be there. 

 (HINT: If someone might go to such a facility, make sure they have a phone they can put on speaker mode while the doctor is in the room, so information is accurately shared with the family.)

[lex24]

One of the things that galls me about the orders (especially at the County level) are the lack of questions being asked.   All we get is generalities.  Which tells us very little.
Questions that I think we deserve answers to:
1.  Who are the people being hospitalized? Demographics- age, gender, comorbidities (or lack thereof) socioeconomic status.  In real numbers.  Historically and this last month.
2. Same questions as to those that are dying.
...
I think we have a right to know the specifics.  Without them, I think the public is not served. And I think the result is more and more will tune out.  (Beyond the basics of masks, social distancing, avoiding large gatherings, washing hands.)

Why do you complain that something isn't there when it is?  At least, we have that for the cases and deaths.  Is it super important to distinguish hospitalizations?  Essentially every county is providing case & death demographics, the states provide it, and the CDC and others provide it nationally.  I suspect it is available for most countries & the world in total.

When you get down to the level of hospitalization in a county and start subdividing it (for instance, how many also have cancer and are in the ICU), you start getting to the point at which individuals can be associated with characteristics.

If you want to look at hospitalization numbers specifically, here's detail but from March
https://www.cdc.gov/mmwr/volumes/69/wr/mm6915e3.htm
You can look at age & ethnicity year to date here
https://www.cdc.gov/coronavirus/2019-nco.../index.htm
If you want trends over time for hospitalizations by age, use this
https://gis.cdc.gov/grasp/COVIDNet/COVID19_3.html

You are right, some of the answers to the questions I raise in 1 and 2 are ascertainable through going to the county and state websites.  But in general with the media we get the generalities.  Simply the raw numbers .  And their unwillingness to question Dr. Cady at all on decisions that have impact well beyond her borders (and that no other health director etc. in this state much less the country have done) is pathetic.

[lex24]

One of the things that galls me about the orders (especially at the County level) are the lack of questions being asked.   All we get is generalities.  Which tells us very little.
Questions that I think we deserve answers to:
1.  Who are the people being hospitalized? Demographics- age, gender, comorbidities (or lack thereof) socioeconomic status.  In real numbers.  Historically and this last month.
2. Same questions as to those that are dying.
...
I think we have a right to know the specifics.  Without them, I think the public is not served. And I think the result is more and more will tune out.  (Beyond the basics of masks, social distancing, avoiding large gatherings, washing hands.)

Why do you complain that something isn't there when it is?  At least, we have that for the cases and deaths.  Is it super important to distinguish hospitalizations?  Essentially every county is providing case & death demographics, the states provide it, and the CDC and others provide it nationally.  I suspect it is available for most countries & the world in total.

When you get down to the level of hospitalization in a county and start subdividing it (for instance, how many also have cancer and are in the ICU), you start getting to the point at which individuals can be associated with characteristics.

If you want to look at hospitalization numbers specifically, here's detail but from March
https://www.cdc.gov/mmwr/volumes/69/wr/mm6915e3.htm
You can look at age & ethnicity year to date here
https://www.cdc.gov/coronavirus/2019-nco.../index.htm
If you want trends over time for hospitalizations by age, use this
https://gis.cdc.gov/grasp/COVIDNet/COVID19_3.html

You are right, some of the answers to the questions I raise in 1 and 2 are ascertainable through going to the county and state websites.  But in general with the media we get the generalities.  Simply the raw numbers .  And their unwillingness to question Dr. Cady at all on decisions that have impact well beyond her borders (and that no other health director etc. in this state much less the country have done) is pathetic.

[fanofourforebears]

One of the things that galls me about the orders (especially at the County level) are the lack of questions being asked.   All we get is generalities.  Which tells us very little.

Questions that I think we deserve answers to:

1.  Who are the people being hospitalized? Demographics- age, gender, comorbidities (or lack thereof) socioeconomic status.  In real numbers.  Historically and this last month. 

2. Same questions as to those that are dying.

3. Curfew-  Given restaurants, bars and essentially all other forms of entertainment are shut down - what is the scientific/medical/statistical evidence behind this move. And I mean specifics.  In other words - is there evidence that activities after 10 have disproportionately added to the spread?  To hospitalizations?  To deaths?

4. SCC 150 mile rule.  What evidence is there that increased rates are as the result of people coming into the County from outside this 150 zone?  Including hospitization rates and death rates.

5. SCC. Contact sports rule and professional and collegiate sports. Same questions.  (BTW- how many College or Pro Bay Area athletes(or those that work at the facilities - coaches, etc) have landed in the hospital or died of Covid.). Is there evidence that these athletes (or those around the team) have infected others at a high rate? 

I understand BC’s “ballast” argument.  But I don’t agree with it.  Because all these moves have consequences upon people that go beyond  the virus.  Economically for some.  Kids and education.  Mental health for some. 

When this hit in March, people for the most part were willing to SIP under the assumption that it would be short term. 9 months in, fatigue sets in.  Understandably. With severe consequences.

I think we have a right to know the specifics.  Without them, I think the public is not served. And I think the result is more and more will tune out.  (Beyond the basics of masks, social distancing, avoiding large gatherings, washing hands.)

Lex, Yes we all deserve answers and if the Public Health Authorities cannot furnish them, they have no "right" to make their public health orders.  Guesswork needs to be stopped and especially considering the consequences.  As I have stated in other post, and hopefully not needlessly beating a dead horse, but how can it be that nine months into this and "they" still have not made sure to have the new virus isolated, identified and truly studied to see what works and doesn't work and what the consequences are of doing or not doing various things both to protect the public until it is discovered how to best treat and maybe even cure this virus or at least learn how to live with it like we have other corona viruses, and of course when the virus goes viral on someone's lungs what is the best mode of treatment?  Isolation and identification is needed, why has it not yet been done?  Yes there are studies and articles that make the false claim of "isolation", but to my knowledge and that of many Medical Doctor's it has yet to be done.  And did you see this ruling in Portugal?

[fanofourforebears]

One of the things that galls me about the orders (especially at the County level) are the lack of questions being asked.   All we get is generalities.  Which tells us very little.

Questions that I think we deserve answers to:

1.  Who are the people being hospitalized? Demographics- age, gender, comorbidities (or lack thereof) socioeconomic status.  In real numbers.  Historically and this last month. 

2. Same questions as to those that are dying.

3. Curfew-  Given restaurants, bars and essentially all other forms of entertainment are shut down - what is the scientific/medical/statistical evidence behind this move. And I mean specifics.  In other words - is there evidence that activities after 10 have disproportionately added to the spread?  To hospitalizations?  To deaths?

4. SCC 150 mile rule.  What evidence is there that increased rates are as the result of people coming into the County from outside this 150 zone?  Including hospitization rates and death rates.

5. SCC. Contact sports rule and professional and collegiate sports. Same questions.  (BTW- how many College or Pro Bay Area athletes(or those that work at the facilities - coaches, etc) have landed in the hospital or died of Covid.). Is there evidence that these athletes (or those around the team) have infected others at a high rate? 

I understand BC’s “ballast” argument.  But I don’t agree with it.  Because all these moves have consequences upon people that go beyond  the virus.  Economically for some.  Kids and education.  Mental health for some. 

When this hit in March, people for the most part were willing to SIP under the assumption that it would be short term. 9 months in, fatigue sets in.  Understandably. With severe consequences.

I think we have a right to know the specifics.  Without them, I think the public is not served. And I think the result is more and more will tune out.  (Beyond the basics of masks, social distancing, avoiding large gatherings, washing hands.)

Lex, Yes we all deserve answers and if the Public Health Authorities cannot furnish them, they have no "right" to make their public health orders.  Guesswork needs to be stopped and especially considering the consequences.  As I have stated in other post, and hopefully not needlessly beating a dead horse, but how can it be that nine months into this and "they" still have not made sure to have the new virus isolated, identified and truly studied to see what works and doesn't work and what the consequences are of doing or not doing various things both to protect the public until it is discovered how to best treat and maybe even cure this virus or at least learn how to live with it like we have other corona viruses, and of course when the virus goes viral on someone's lungs what is the best mode of treatment?  Isolation and identification is needed, why has it not yet been done?  Yes there are studies and articles that make the false claim of "isolation", but to my knowledge and that of many Medical Doctor's it has yet to be done.  And did you see this ruling in Portugal?

[BostonCard]

A few comments:

First, in the midst of a fast moving pandemic, uncertainty is unavoidable.  Yes, it would be great to have all the data, and target activities spreading COVID-19 with surgical precision, but alas, it will take years to collect and analyze all the data.  We have imperfect knowledge of transmission dynamics of influenza, which has been around for centuries.  At best, we are dealing with imperfect information and making educated guesses.

I suppose a more honest accounting would demand an acknowledgement of these facts.  Perhaps more transparency about the limitations of our scientific knowledge is called for.  But there is also an obligation on the other side not to weaponize scientific uncertainty.  I think there is a tendency of opponents of certain public policy measures of taking scientific uncertainty and turning it into known-nothingism.  That's not helpful.

A better debate would start by acknowledging the uncertainty and the competing costs for various policy choices in that uncertainty.  Shutting things down (especially if it has little effect on the pandemic) has a heavy cost, to businesses, to employees, to schoolchildren, to physical and mental health.  The flip side also carries costs, especially on vulnerable people, but the virus is capricious, and it can strike younger, healthy people (though rarely), cause long term sequelae even to those who recover, and has even been associated with a pretty serious inflammatory disorder in kids even as most of them are minimally affected.  There are also costs to hospitals and healthcare workers of continuing to operate in a near constant state of overload.  Whether the uncertainty should be calibrated towards the needs of the former or the needs of the latter is a discussion worth having.

That being said, one thing that is not well understood is that we are not capable of calibrating our activities to a certain level of infection, but rather to a certain growth rate.  In that context, unless you set your threshold as "no level of infections, hospitalizations, and deaths is unacceptable" then so long as the caseloads are growing, we will eventually hit that level.  So, even if you think ~150,000 daily cases, 90,000 hospitalizations, and 1500 deaths/day is acceptable and draw your line at 300,000 cases, 150,000 hospitalizations, and 3000 deaths/day, as long as caseloads are growing, then you will eventually get to your limit, barring an intervention or some change in the transmission dynamics.

BC

[BostonCard]

A few comments:

First, in the midst of a fast moving pandemic, uncertainty is unavoidable.  Yes, it would be great to have all the data, and target activities spreading COVID-19 with surgical precision, but alas, it will take years to collect and analyze all the data.  We have imperfect knowledge of transmission dynamics of influenza, which has been around for centuries.  At best, we are dealing with imperfect information and making educated guesses.

I suppose a more honest accounting would demand an acknowledgement of these facts.  Perhaps more transparency about the limitations of our scientific knowledge is called for.  But there is also an obligation on the other side not to weaponize scientific uncertainty.  I think there is a tendency of opponents of certain public policy measures of taking scientific uncertainty and turning it into known-nothingism.  That's not helpful.

A better debate would start by acknowledging the uncertainty and the competing costs for various policy choices in that uncertainty.  Shutting things down (especially if it has little effect on the pandemic) has a heavy cost, to businesses, to employees, to schoolchildren, to physical and mental health.  The flip side also carries costs, especially on vulnerable people, but the virus is capricious, and it can strike younger, healthy people (though rarely), cause long term sequelae even to those who recover, and has even been associated with a pretty serious inflammatory disorder in kids even as most of them are minimally affected.  There are also costs to hospitals and healthcare workers of continuing to operate in a near constant state of overload.  Whether the uncertainty should be calibrated towards the needs of the former or the needs of the latter is a discussion worth having.

That being said, one thing that is not well understood is that we are not capable of calibrating our activities to a certain level of infection, but rather to a certain growth rate.  In that context, unless you set your threshold as "no level of infections, hospitalizations, and deaths is unacceptable" then so long as the caseloads are growing, we will eventually hit that level.  So, even if you think ~150,000 daily cases, 90,000 hospitalizations, and 1500 deaths/day is acceptable and draw your line at 300,000 cases, 150,000 hospitalizations, and 3000 deaths/day, as long as caseloads are growing, then you will eventually get to your limit, barring an intervention or some change in the transmission dynamics.

BC

[oldalum]

The initial response by local public health officers imposing restrictions on movement etc. seems justifiable and necessary as an emergency response by experts to a new and poorly understood pathogen. Almost 9 months later, I think it actually serves Cody et al. poorly, as well as the public, to have them be solely in charge of the public health aspects of the pandemic response. Our elected officials have had plenty of time to get up to speed on the virus, infection rates, prevention measures, treatment, demographics, etc. It seems to me that they should be making the decisions at this point, informed by the advice of their public health professionals, much as is ostensibly happening at the state level.

[oldalum]

The initial response by local public health officers imposing restrictions on movement etc. seems justifiable and necessary as an emergency response by experts to a new and poorly understood pathogen. Almost 9 months later, I think it actually serves Cody et al. poorly, as well as the public, to have them be solely in charge of the public health aspects of the pandemic response. Our elected officials have had plenty of time to get up to speed on the virus, infection rates, prevention measures, treatment, demographics, etc. It seems to me that they should be making the decisions at this point, informed by the advice of their public health professionals, much as is ostensibly happening at the state level.

[Goose]

It seems to me that they should be making the decisions at this point, informed by the advice of their public health professionals, much as is ostensibly happening at the state level.

Obviously I don't sit in the meetings that make the decisions, but I strongly suspect Dr. Cody does sit down with the supervisors and tells them what she wants to do and why. If they don't like it, they push back, some dialog ensues, and a compromise is reached. Dr. Cody has the authority to do what she wants, but she knows without the Supervisors support, it won't work. They control the enforcement mechanisms, she does not. If they won't make stores operate at 10% capacity (by issuing tickets, whatever else), she is powerless to do so. Traditionally, this model has worked pretty well because the Supervisors don't have to take the political heat from the decision. The Country Health Officer, who doesn't have to run for election in two years, takes the heat.

[Goose]

It seems to me that they should be making the decisions at this point, informed by the advice of their public health professionals, much as is ostensibly happening at the state level.

Obviously I don't sit in the meetings that make the decisions, but I strongly suspect Dr. Cody does sit down with the supervisors and tells them what she wants to do and why. If they don't like it, they push back, some dialog ensues, and a compromise is reached. Dr. Cody has the authority to do what she wants, but she knows without the Supervisors support, it won't work. They control the enforcement mechanisms, she does not. If they won't make stores operate at 10% capacity (by issuing tickets, whatever else), she is powerless to do so. Traditionally, this model has worked pretty well because the Supervisors don't have to take the political heat from the decision. The Country Health Officer, who doesn't have to run for election in two years, takes the heat.