Wednesday, May 6, 2020

Concrete Proposals For Reopening

Last night I posted the conclusions of some studies regarding the "dynamics of transmission" of the COVID pandemic. Assuming the correctness of those studies, my conclusion was that, based on the relatively lower transmissibility of the Wuhan virus--relative to seasonal flu, for example--we should prioritize our strategy to protect the most vulnerable while deploying preventive measures that are targeted to take advantage of what we now know regarding transmission of the virus. To repeat:

close & prolonged contact is required for #COVID19 transmission. 
Casual, short interactions are not the main driver of the epidemic though keep social distancing!  
susceptibility to infection increases with age (highest >60y) 
(b) avoid close, sustained contact indoors & in public transport, & maintain personal hygiene.

Regarding the demographics of who is at greatest risk from the Covid pandemic, it's well known by now that the elderly are at the greatest risk by far. From comparisons of the current year's mortality profiles for both flu and Covid, a differing profile emerges. Whereas flu (at least for this year, a very low mortality year) does affect young children to a greater extent than Covid and then increases its threat until plateauing after age 60, Covid is a bit different. Covid has virtually no effect on the very young--say, < 15 years--but its threat begins to increase rapidly after age 30. In contrast to the flu, which basically plateaus among seniors, the threat of death from Covid simply continues to increase ever more sharply with increasing age. That, of course, explains the extraordinarily high death rates among closely packed groups of seniors.

With that in mind, here is a portion of an article by Dr. Scott Atlas at The Hill--How to reopen society using medical science and logic. I've included Atlas' specific proposals. I don't say that I agree with all of them. For example, it might be helpful to have some studies on the effectiveness of countermeasures such as masks in higher risk environments such as public transportation. Nevertheless, these are fairly concrete proposals that are based on largely logical considerations, and so can serve as a useful basis for rational discussion--not only for the present time but also in the event of a future recurrence of the pandemic. With that, Scott Atlas:

Here are specific and logical steps to end the lockdown and safely restore normal life:

First, let’s finally focus on protection for the most vulnerable — that means nursing home patients, who are already living under controlled access. This would include strictly regulating all who enter and care for nursing home members by requiring testing and protective masks for all who interact with these highly vulnerable people. ...


Second, those with mild symptoms of the illness should strictly self-isolate for two weeks. It’s not urgent to test them — simply assume they have the infection. That includes confinement at home, having the highest concern for sanitization and wearing protective masks when others in their homes enter the same room.

Third, open all K-12 schools. Children have nearly no risk of serious illness from COVID-19. Exceptions exist, as they do with virtually every other clinically encountered infection, but that should not outweigh the overwhelming evidence to the contrary. Again, standards for consciously protecting elderly and other at-risk family members or friends would still be employed.

Fourth, open businesses, including restaurants and offices, but require new standards for hygiene, disinfection and sanitization via enforceable, more stringent regulations than in the past. It is reasonable to post warnings for customers who are older or in other ways vulnerable. Avoid unnecessary requirements for spacing of customers, though — it is not logical that otherwise healthy adults, especially younger age groups, should be isolated or maintain a six-foot spacing from each other. If infection is still prevalent, socializing among these low-risk groups represents the opportunity for developing widespread immunity and eradicating the threat.

Fifth, public transportation, the lifeblood of much of the workforce in cities, should resume. In addition to new standards of cleanliness and hygiene that passengers would welcome, regional authorities could require barrier masks for passengers. ...

Sixth, parks and beaches should open. The closure policy was aiming to prevent social mingling. There is no scientific reason to insist that people remain indoors.


  1. Good article. Nice to mention Nursing Home issue.

    What would be useful additionally:

    1. Information updated daily, on people who are tested, where they got it from. My guess is Nursing Homes are 50%, and 10% Health Care workers. I am picking up this information anecdotally. I would like it down to a county level. As well as % positive down to a county level for daily test counts.

    2. Best practices for protecting retail employees.

    3. Best practices for treatment regimes. My gut feeling is a lot of places are not using Hydroxychloroquine due to Orange Man Bad Syndrome. Or using it late.

    4. Analysis of best practices. Your Florida vs NY article was great.


  2. Cuomo gave info about where the NY infections are coming from. Lots of people supposedly working from home.

  3. Insert key, turn key, open door, flip sign to OPEN.

    After some embarrassing local shenanigans we got something right:

    Tom S.