Author Topic: Two weeks in, the path forward on coronavirus  (Read 902 times)

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Offline jmyrlefuller

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Two weeks in, the path forward on coronavirus
« on: March 26, 2020, 01:45:35 pm »
by J. Myrle Fuller

On March 11, 2020, the World Health Organization officially declared coronavirus disease 2019 a pandemic. Here in America, sporting events were already being moved to empty arenas (and it would not be long before tournaments and whole seasons were postponed) and the first steps toward severe "social distancing" and occupancy restrictions had begun to take effect, a sure sign that after several years of false alarms, the United States (and, for that matter, much of the rest of the world), was facing a viral threat worse than that seen in most of our lifetimes.

As I write this, it is now March 26, fifteen days after those measures began. That is important. The average incubation time of this virus, from infection to onset of symptoms, is about five days, and it can take up to nine days more before one can secure a test, have it administered, process it, and receive the results—meaning the current number of cases is in reality about two weeks behind the conditions that led to the infection. This of course poses a challenge to efforts to mitigate the disease.

Yet since we are now two weeks in, we should now begin to see whether our efforts at social distancing, along with many of the more draconian (and dare I say fascist) measures of closing schools and "non-essential" businesses, stay-at-home orders and banning any substantial private or public "gatherings" are actually working. In theory, they should be; it's very difficult for this particular virus to spread when people have no reason or ability to be in close contact with one another. So we should start seeing a decline in new cases as the tests begin to pick up infections from after these measures took effect.

Eventually, though, these measures will not be sustainable long-term. Small business owners will need income, people will need haircuts, and eventually the need for human contact after weeks of isolation will become overwhelming. So how do we do this? Over the next couple of weeks, federal, state and local governments need to take a multi-pronged approach to assessing the state of the virus's spread and continuing to limit its impact while allowing areas that have not yet been impacted to resume normal life.

Identifying areas of community spread

It is true that many areas, including rural counties, have seen active coronavirus cases. In most cases, those came from an overseas traveler or college student returning home from an area with community spread—where the virus is transmitting from person-to-person and is thus more difficult to avoid. In many cases, these cases are promptly quarantined (and others suspected of potential infection under similar circumstances are also placed under a precautionary isolation), preventing the virus from spreading in their communities. So far, those measures appear to have worked.

In Allegany County, New York, two cases of coronavirus were identified from a twentysomething who had returned from Italy and a five-year-old. At one point there were nearly 100 people being watched by the county for symptoms. Today, that number is down to eight, including the two positive cases. In fact, there is so little evidence of the virus in the community that the county has not even had to test anyone in days. In neighboring Cattaraugus County, there remain zero confirmed cases, and the number of people being watched is also declining. Chautauqua County, the next county to the west, has three cases, all of whom brought the virus from either Buffalo or New York City; they are among 11 under mandatory quarantine and several dozen others being watched as a precaution.

Travel restrictions

A community with no community spread is safe, but to keep it that way, people coming in have to be isolated to make sure they do not carry the virus back in from an area that still has community spread. Once areas with community spread and areas that do not have such spread are identified, they can be isolated with travel restrictions. Since areas with community spread will still be under restrictions, there would be little to no reason for residents to go there, meaning the main enforcement would be making sure that those in community spread areas do not leave.

This was a key measure in the success of Wuhan's mitigation efforts, though their mandatory actions likely are far too strong for America to undertake. By taking the isolation measures that have so far been a success on the individual level at small scales, and upscaling it to communities, it protects the communities that have not had the virus go, well, viral. Since most of the communities that can be counted as coronavirus successes are rural, they are less likely to have the kinds of mass gatherings that lead to large crowds; there will likely need to be some restrictions on those until community spread abates in the cities.

Get back to work

Once we isolate the community spread and ensure that further cases do not come to introduce the virus, we can put the areas that are no longer under a threat back to work by reopening their businesses. There would still have to be some restrictions on keeping residents of community spread areas from having to come into work, and for the short-term some social distancing would still be advisable. But, if areas that have thus far avoided community spread can continue to prevent it, it is not out of the question to think that churches could open Easter services to their congregations.

And, if these measures continue to reduce the rate of contagion even in areas where community spread was rampant, much of the country could be back to work by late April or early May as recoveries rise and new cases drop to as close to zero as possible. Admittedly a few places that are particularly hard-hit like New York City might take longer to recover, but the rest of America is not New York City, and we cannot punish the whole country for their outbreak.
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