COVID19 group A and group B sharing strategy.

[JohnRoberts]

Perhaps we could explore Squarewave's idea further...

There is increasing pressure to not completely trash the economy by shutting it down completely to flatten the infection spread curve, too long.

Givens:
- we cannot completely stop the spread of this virus, only slow it. (This is good enough if we can flatten the growth curve enough to avoid overloading health care capacity, while ramping up that capacity.)
- this is a novel virus so inadequate herd immunity, and no vaccines (yet). The virus will probably return next year, mutated or not.
- short term social distancing strategies are not compatible with full economic functionality

Risk:
-exposing susceptible populations to virus that can result in death from a shared workplace.
-young people contracting virus harmlessly to themselves but exposing older family members who are at risk.

Options:

-Increased testing by orders of magnitude, so not only can everybody be tested, but people in contact with others can get retested regularly. Instead of dividing population by age or risk profile, test for infection history/status.

Stuff I do not know... After people contract covid-19, survive and regain health, presumably they are not contagious or susceptible to reinfection?

So we may need more than two groups.
1-infected but recovered and healthy
2-not infected at risk
3-not infected low risk
4-infected and contagious


We need to figure this out because we can't remain shut down for too long. Apparently infected individuals can be symptomless so not simple to ID all #4s

I have been sheltering in place for decades, so I am not talking about me. 

JR

PS: This still sounds like bad science fiction.

 

[gyraf]

For this to work we first of all need quick, plentiful and reliable testing

Unfortunately we are still waiting for this to happen despite authorities repeatedly telling us otherwise

I'm sure there will come out new strategies when/if we get to a point where diagnosis and detection is easy

Until then I believe there's no alternative to closing everything down tightly. In the coming week we'll learn how efficient that strategy is - at least locally like here in Denmark.

I don't want to be scaremongering, but looking carefully through figures, models and known data - I must admit that I'm genuinely scared of what I see coming in New York for the next 4-5 weeks. I hope so much that I'm wrong on this.

Please stay safe..!

/Jakob E.

 

[Bo Deadly]

The main principle behind the Group A / B system is not just about staving off economic depression. The core principle is actually to take resources from the group that does not need them and give them to those who do. If you consider yourself to be in Group A, then you believe that you are healthy enough to survive Coronavirus without any perminent effects. You would not receive any testing at all. You would be assumed to have Coronavirus already or had it and recovered. There would be no social isolation. You can go about your Business with a capitol B. If you are a vulnerable individual or you just have concerns for whatever reason, you would declare yourself to be in Group B and receive special treatment. That would include testing and privileged access to resources like special hours or days for doctors, dentists,  the grocery store and so on. You would diligently avoid contact with Group A and wear a mask whenever you leave your home not just for your own protection but, perhaps more importantly, so that people can clearly identify you and avoid you.

By my personal estimations based personal accounts observed in news reports and some official albeit somewhat fragmented data from official sources, it appears that you have to be a particularly unhealthy individual to be permanently affected by Coronavirus. So Group A should be quite large in theory. Perhaps 90% of the entire population. Of course there is still a large amount of fear associated with watching red dots on a map slowly spread. But over time people will start to realize that they are not in danger if they are vaguely healthy. Then more resources can be focused on Group B who genuinely need them.

How exactly would it "work"? Basically if you request as test, you're are declaring yourself to be in Group B. You could present that test result (in the form of a printout or more likely a square bar-code on your mobile device that anyway can scan with their phone and superficially verify) to gain privileged access to the DMV, barber, etc. However, and this is "the catch", if you are in Group A, you are assumed to be infected or have been and recovered and as such, they would not receive any testing. Group A would not be restricted in any way other than they MUST NOT come into contact with anyone in Group B.

This is where people usually get confused. They say "but then everyone in Group A will get infected and it will overrun the medical system you idi..". The key thing to understand is that people in Group A should be relatively healthy and as such they should not require significant medical resources. Some will no doubt. People will misjudge their health status. People who have a substance abuse problem will try to mask their condition and pretend that they are ok when in fact they should be in Group B. The system is not without it's flaws. But the overall effect will be that we can focus what limited resources we have on the people that really need it. We can then rigorously test Group B and track their progress. The whole situation becomes much more manageable. And the economy is much better for it.

 

[cyrano]

The main problem with this plan is that it won't stop spreading the virus. It's clear that people will get infected and the virus will kill a lot of those with health problems. But it will also kill a lot of healthy people under 50.

Oh, and BTW, the virus has already mutated.

Another thing we don't know is if the virus will spread through animals. Dogs are more or less confirmed to be vulnerable, but we're not sure if the infection is one-way, or both ways.

It's reasonably sure isolation works, if started soon enough. China, Korea, Japan all succeeded in avoiding the worst.

The numbers seem to point at it being too late for the USA, leading to the same situation as in Italy. With the UK going the same direction, this could be bad news for the rest of the world.

More mutations will surface. Any one of those could be dangerous, or not. Most wouldn't even be noticed, but we don't know for sure if the next one is innocuous..

 

[JohnRoberts]

This is obviously a simultaneous equation with multiple variables.

We need to both reduce harm to frail populations, while avoiding too much lost opportunity (economic) for the youts.

I think more testing is a vehicle to help slow/prevent spread of the virus between groups while retuning to something closer to normalcy.

Not simple which I why I raised here, with this smarter than average group.

JR

 

[Script]

Honestly, I think this Group A / B idea is utter bogus and potentially dangerous.

As for danger, and I am hopelessly exaggerating now on purpose and for a purpose:
- how about making Group B people wear a clearly visible corona-shaped batch at all times ? Once truly a part of that group, they are unlikely to ever leave that group again anyway, no?
- And instead of distributing barcodes on smartphones (as these might get lost or stolen) we tatoo the barcode directly on people's arms ?
- Or since Group B constitutes only 10% or 20% of all people, we allow them to leave their (self-chosen !?) home-confinement only every 8th or 9th day. The rest of the time we keep them safely locked away for their own good.

See what i mean ?

Mind you, I exaggerate on purpose to make this point.

---------------------
Securing resources, yes, most certainly. that's worth talking about.

I do see a near-distant future, where not only international travelling requires a health certificate.

But I also tend to believe that there are instances in almost all affected countries where people volunteer (like those doctors in Korea !?) to help alleviate the situation and uphold the infrastructure. This group we could say consists of so-called system-relevant people. Now we can discuss what should and what should not be considered system-relevant.

------------
Also, on a different note, the Chinese sent doctors and equipment to Italy. I know that not everybody likes that idea for narrow-minded and purely political reasons, but it is based on what can be identify as a move of solidarity.

And I have to say, at any time, I prefer solidarity over any kind of superimposed over-regulation...

 

[JohnRoberts]

Honestly, I think this Group A / B idea is utter bogus and potentially dangerous.

I noted at  least 4 different groups... but I clearly don't know enough to craft a solid plan.

we need more testing to identify actual infectious people and perhaps quarantine them...

As for danger, and I am hopelessly exaggerating now on purpose and for a purpose:
- how about making Group B people wear a clearly visible corona-shaped batch at all times ? Once truly a part of that group, they are unlikely to ever leave that group again anyway, no?
- And instead of distributing barcodes on smartphones (as these might get lost or stolen) we tatoo the barcode directly on people's arms ?
- Or since Group B constitutes only 10% or 20% of all people, we allow them to leave their (self-chosen !?) home-confinement only every 8th or 9th day. The rest of the time we keep them safely locked away for their own good.

See what i mean ?

Mind you, I exaggerate on purpose to make this point.

do you have an alternate suggestion?

---------------------
Securing resources, yes, most certainly. that's worth talking about.

I do see a near-distant future, where not only international travelling requires a health certificate.

used to be a concern of catching something from travel, I recall getting shots just to travel to EU.

But I also tend to believe that there are instances in almost all affected countries where people volunteer (like those doctors in Korea !?) to help alleviate the situation and uphold the infrastructure. This group we could say consists of so-called system-relevant people. Now we can discuss what should and what should not be considered system-relevant.

------------
Also, on a different note, the Chinese sent doctors and equipment to Italy. I know that not everybody likes that idea for narrow-minded and purely political reasons, but it is based on what can be identify as a move of solidarity.

If China now has surplus capacity it seems fair to support Italy, I won't second guess their motives.

And I have to say, at any time, I prefer solidarity over any kind of superimposed over-regulation...

I would like to see more solidarity from citizens listening to the advice of public health authorities.

China is authoritarian and made its citizens do what they wanted. We mainly ask and hope they have the good sense to follow instructions.

JR

 

[Script]

I noted at  least 4 different groups...

Almost infinitely more.
- number of people per household (single, couple, kids, two generations, three generations)
- employment situation
- commuting (and if so how far and to where)
- differences in income
- city mouse / country mouse
etc etc

we need more testing to identify actual infectious people and perhaps quarantine them...

Yes, as WHO recommends: 'testing testing testing.' And ideally with reliable results within 5 minutes. But until then...

do you have an alternate suggestion?

No, I'm just a dumb part-time DIY guy who doesn't even know how to spell Ohms Law correctly

But I have grown tired several years ago already of the all too ubiquitous trend of self-aggrandizing elite bashing. Yes, we do have several politicians up there who are beyond belief. But should my toilet be clogged with too much toilet paper (haha, not funny any more ! ) and I can't DIY fix it, I call for a plumber and I expect that person to be a damn expert and not one of the next best guys who claim they can swing a hammer. But I am digressing.

It seems that one by one, even the dumbest of our leaders (elite bashing -- careful ! ) are starting to listen to experts, instead of only eyeing laissez-faire herd-inmunity, which -- should an explosive infection spike happen -- more people will pay for with their lives than we could possibly want.

If China now has surplus capacity it seems fair to support Italy, I won't second guess their motives.

Neither would I, but they may be just repaying for the help they received from Italy earlier. I really want to believe there's more to it. And looking at Hubei right now.... we have become somewhat vulnerable, all of us, and maybe it's time to acknowledge that. But I definitely don't believe we'll be assimilated all one day into the United World of China

I would like to see more solidarity from citizens listening to the advice of public health authorities.

Dito.

 

[Script]

Here's what you have to do every morning in Japan by default since long ago, if you want to drop off your kids at kindergarden.
- measure their temperature before leaving home (if they have a fever, you can't bring them)
- measure their temperature again on entering class (if they have a fever, you have to take them back home).

Could that be an idea once we have reliable and widely available testing kits?

 

[gyraf]

..safely locked away for their own good..

I'm 100% with you on this, Script - implications are really scary when you take a closer look and then add lowest-denominator politics to the model..

/Jakob E,

 

[JohnRoberts]

I wonder what the SOTA technology is for IR temperature measurement from modest distance...  Most of the scans I see for passengers with fever require physical contact or very close distance....

That would be a nice feature for my google glasses to be able to scan around the room and see who has a fever. I'll bet some governments are already doing this.

https://satir.com/application/thermal-imaging-and-fever-detection

Apparently multiple commercial solutions... I want my personal smart phone ap...

----

There is a lot of media drama about POTUS trying to negotiate an end date with the COVID19 virus.... that is just what he does. He laid down a directional anchor, with date marker, and will now negotiate a possible plan to restart the economy. This is not instead of fighting the virus, just planning for the near future, kind of his day job.

JR

 

[gyraf]

..that sort of FLIR realtime screening was already part of the past SARS-scare, mainly in airports..

/Jakob E.

 

[JohnRoberts]

..that sort of FLIR realtime screening was already part of the past SARS-scare, mainly in airports..

/Jakob E.

Might be useful for when we return to typical workspaces to monitor coworkers health 24x7.  Stores could monitor shoppers, while policing shoppers could get testy.

JR 

 

[JohnRoberts]

Some merchants are installing sneeze shields to protect workers from customers.... sounds smart.

JR

 

[JohnRoberts]

The US is a pretty large country so COVID19 outbreaks are unlikely to all peak at exactly the same time across the entire country.

There might be some merit in sharing ventilators from less stressed areas with more stressed areas... Right now there are worries about NYC, Northwest, NO, and perhaps FL as new yorkers escape to down there.

It is probably against human nature to give up such dear equipment in the face of pandemic, but surely we have many ventilators sitting underused across the country.

Just a thought.

JR 

 

[cyrano]

Here's what you have to do every morning in Japan by default since long ago, if you want to drop off your kids at kindergarden.
- measure their temperature before leaving home (if they have a fever, you can't bring them)
- measure their temperature again on entering class (if they have a fever, you have to take them back home).

Could that be an idea once we have reliable and widely available testing kits?

That's just one of the reasons Japan headed off a mass infection immediately. It just requires a population willing to obey.

Quite the opposite of the US, seemingly.

 

[JohnRoberts]

A variation on my borrowing underused ventilators from other parts of US, how about replacing the loaned out ventilators with new ones from the new production... New later for used now is a better trade deal for all involved...

Of course I have no idea about the numbers needed... just seems like this could help.

JR 

 

[gyraf]

I think the resistance to the lending of medical hardware is because the "peak" of the infection where overload occurs is expected (from seeing ir elsewhere) to last so long that in effect there will be a very-long overlap. And you cant expect hospitals to give back hardware that is difference between life and death.

 

[JohnRoberts]

I think the resistance to the lending of medical hardware is because the "peak" of the infection where overload occurs is expected (from seeing ir elsewhere) to last so long that in effect there will be a very-long overlap. And you cant expect hospitals to give back hardware that is difference between life and death.

Indeed even with the promise of a replacement respirators coming soon, no bureaucrat wants to be remembered as the guy who gave away the life saving gear, that they desperately needed later.  :-[

===

I am pleasantly surprised, but not really surprised to notice that my local clinic is only taking patients via tele-doctoring (phone-computer link).  I hadn't seen any cars there for last week so checked the door before my 5 mile bike ride yesterday, and saw the posted notice. 

I'm cool, my annual check up requiring a blood draw is still a few months off, and I could probably get them to renew my thyroid medication prescription without the blood draw as my dosage has not changed for several years.

---

I made my once a week grocery shopping trip today but hit the store a couple hours earlier than normal to avoid crowds, and hopefully get better supplies. I needed some cornmeal but there was only one brand of self rising flour on the entire aisle. Several other grocery items were thinly stocked if at all...  I did manage to finally score a 4 pack of TP but there was pretty slim pickings on that entire shelf area... I don't know if it is a matter of keeping the shelves stocked, or supply chain weakness. I am guessing a little of both.

===

I just realized that every time I grab the door handle at the post office to check my PO box for mail, I am touching hands with every other neighbor who used that same door (the postmaster said she cleans it several times a day).  So far there is only one confirmed case in my entire county, but still early days. Even covid doesn't want to visit here.  :

----

Back slightly on topic, if we could do blood tests to identify markers that individuals already contracted  COVID19 and have mounted an immune response and recovered, presumably not to get infected again, or infect others, they should be free to return to work. I think there are still some unknowns about mild cases, but lots of speculation.

JR

 

[Script]

Instead of lending out equipment, they could bring patients to where currently not needed equipment is. They do that between  France and Germany.

----
Recoveries:
Could check for antibodies via simple blood sample. I read the Brits were working on a gadget for distribution to households via Amazon. But not definite yet, since no proof that it actually works. So maybe just part of 'please all stay calm'-news strategy? But at least, it sounds soothing.

Also, the Chinese say they tested monkeys and seem to have found that once recovered, those monkeys did not  contract the infection again. Unfortunately there's no link to the study in this article in Japanese:
https://mainichi.jp/articles/20200319/k00/00m/040/138000c

The claim is that there is no reinfection, which would be nice, but cases of test being negative, yet patient not fully recovered,, so resurgence. -- Study about Diamond Princess points to the same.