[Goose]

While this is an issue, at least in  San Mateo County a much larger issue is that often there are many other people in the household. It is impossible to isolate in that condition, even if you have sick pay. Further, the population doesn't trust the County (or government in general) enough to accept other accommodation if offered. Naturally the other people in the household are contacts and should quarantine. They also can not/do not, for the same reasons. This has been an ongoing problem all along.

I think what you say makes a lot of sense for a deterministic spread pattern.  However, I'm starting to wonder if families get it (aside from impact on elderly or susceptible members) how much this impacts the overall spread.  If super-spreader events are much more significant, the biggest risk is an actively infectious person winds up in a location that's very bad -- poor ventilation, crowded, long duration, etc -- perhaps as a service worker.  The worst scenario is someone who is working in nursing facilities or places like that.  Kids aren't going to concerts and I would think they hang out in small groups of friends.  Elderly aren't the active spreaders.

It is beyond question that an infected person who has lots of contact with the public over a long period of time can spread the disease widely. However, at least in SMC the home setting for many infected people is poor poor ventilation, crowded, and long duration. The other people in the household often do get it under those circumstances, and many of them are the service workers you reference. Dr. Morrow is attributing 50% of the SMC county cases to this type of spread. How good a number that is I can't say, but if it is even close it is a big driver. Not "super spreader" in the sense that in a 10 person household maybe not all 10 get it, but if even 5 do, Reff is 5. That is really hard to overcome, and contact tracing won't help if people won't/can't cooperate.

[Goose]

While this is an issue, at least in  San Mateo County a much larger issue is that often there are many other people in the household. It is impossible to isolate in that condition, even if you have sick pay. Further, the population doesn't trust the County (or government in general) enough to accept other accommodation if offered. Naturally the other people in the household are contacts and should quarantine. They also can not/do not, for the same reasons. This has been an ongoing problem all along.

I think what you say makes a lot of sense for a deterministic spread pattern.  However, I'm starting to wonder if families get it (aside from impact on elderly or susceptible members) how much this impacts the overall spread.  If super-spreader events are much more significant, the biggest risk is an actively infectious person winds up in a location that's very bad -- poor ventilation, crowded, long duration, etc -- perhaps as a service worker.  The worst scenario is someone who is working in nursing facilities or places like that.  Kids aren't going to concerts and I would think they hang out in small groups of friends.  Elderly aren't the active spreaders.

It is beyond question that an infected person who has lots of contact with the public over a long period of time can spread the disease widely. However, at least in SMC the home setting for many infected people is poor poor ventilation, crowded, and long duration. The other people in the household often do get it under those circumstances, and many of them are the service workers you reference. Dr. Morrow is attributing 50% of the SMC county cases to this type of spread. How good a number that is I can't say, but if it is even close it is a big driver. Not "super spreader" in the sense that in a 10 person household maybe not all 10 get it, but if even 5 do, Reff is 5. That is really hard to overcome, and contact tracing won't help if people won't/can't cooperate.