Coronavirus

[SageBrush]

Looks like deaths are bending horizontal.

Hardly

 

[LN1_Casey]

Hawaii has just decided to impose 14 day quarantines on inter-island travel. Thus, if you fly from Maui to Molokai you need to self-quarantine for 14 days. This could be a unique opportunity to see some isolated populations with adequate healthcare and tropical temperatures. Let's see if the health department is good enough at tracking down active cases so that we might achieve a COVID19-free island or two.

Has Hawaii forbidden the travel of passenger planes to and from the Islands? I'd think it'd be difficult to completely eliminate from the island if people still travel freely to and from. Inter-island can be very helpful for the outlaying islands, but the ones with international/open airports probably will still get the occasional flare up.

 

[LN1_Casey]

Hardly

No, it is.

 

[SMAlset]

Santa Clara County stay-in-place extended until May 3. Just announced on noon news.

 

[SageBrush]

No, it is.

Dates 1 - 4 are noisy. Try from the 5th

 

[AlanSubie4Life]

Looks like some significant extra test capacity may have come online today! Really going gangbusters to get to 17k cases by noon. Guess we'll have to wait for end of day update to see exactly what happened as far as testing goes.

Sort by "Tot Cases/1M Pop" to see comparable numbers (and ignore the tiny population areas). The US is between Brunei and Qatar, below all the Scandinavia utopias, etc.

We'll be in the top 10 by that metric (in countries with more than 500 cases) by end of next week. Certainly going to outdo those pitiful Scandinavian utopias. They've got nothing on us.

Well, it's not nearly the end of this week yet, but we've already outdone the sad Scandinavian utopias, in spite of Sweden's best efforts to keep up. Lots of those backwards European countries we need to outdo still, though.

We're now about #16 in countries with more than 500 cases. And we're only 46% below France, and securing a coveted top 10 spot. Should be able to close that gap by Saturday, though the limited testing capacity may make it a tight race.

Looks like America is coming up big yet again!

 

[XHabjab]

Oh so Giuliani is a medical researcher these days? I would rather lick public doorknobs than get "info" from Giuliani.

Okay, so the choices are:

• lick public doorknobs
• get "info" from Giuliani

Okay Alex, I'll take "Action versus Advice" for $400.

 

[N5329K]

Has Hawaii forbidden the travel of passenger planes to and from the Islands? I'd think it'd be difficult to completely eliminate from the island if people still travel freely to and from. Inter-island can be very helpful for the outlaying islands, but the ones with international/open airports probably will still get the occasional flare up.

No, travel is still possible (though flights have been cut way back and fly mostly empty). But Hawaii requires inbound travelers to self-quarantine for 14 days, though exactly how they will enforce that is an unknown. My daughter just flew home from college in Honolulu and reported the lone Alaska Air 737 flight to San Jose flying that day had exactly 6 pax on board.
Robin

 

[ZeApelido]

TSA checkpoint travel numbers for 2020 and 2019

Flight travel has plummeted. I mean expected, but the stark difference at beginning vs end of the month...

 

[Papafox]

Has Hawaii forbidden the travel of passenger planes to and from the Islands? I'd think it'd be difficult to completely eliminate from the island if people still travel freely to and from. Inter-island can be very helpful for the outlaying islands, but the ones with international/open airports probably will still get the occasional flare up.

Hawaii cannot simply say that no one from other states can come in, it's not legal to do so, but the self-quarantine effectively discourages tourism because who wants to spend their Hawaii vacation stuck in their hotel room? Returning residents to Hawaii must also self-quarantine. The residents of neighbor islands (every island except for Oahu) believe they'll be safer if there's less mixing of travelers between the islands and they're the ones who have been pushing for the inter-island self-quarantine rule.

One of the issues we have in Hawaii right now is that inter-island flights are used for both cargo and passengers. If you ground the planes, the cargo doesn't move (except on the all-cargo airlines) and so there will be some flights going between islands that are primarily to carry cargo down below but with very few passengers.

 

[bkp_duke]

View attachment 527947

No, it is.

Cracks me up when I see people arguing about trend lines on graphs with NO ERROR BARS.

(facepalm)

 

[bkp_duke]

TSA checkpoint travel numbers for 2020 and 2019

Flight travel has plummeted. I mean expected, but the stark difference at beginning vs end of the month...

Yeah, it's bonkers. And yet some people still don't get the seriousness of things. When I told a client today that I would not travel to setup core routers for their new datacenter, they asked "what if we send a private plane?". Honestly, I did an eyebrow raise and a facepalm at the same time.

 

[winfield100]

View attachment 527947

No, it is.

It’s a _log_ scale
2 is 30%
4 is 60%
5 is 70%
Look at the y axis
More data is necessary

 

[Xd85]

apologies for crossposting (UV thread gotten a bit stale), anyone know about application of Pulsed UV Machines typically used to sanitize entire rooms to sterilize PPE? wavelength is similar (200-400nm) but need to understand duration not to deteriorate mask materials.

mods please move/delete as necessary.

 

[Singuy]

It is interesting to see how certain hot spot areas are just overwhelming the hospital system while in other areas Covid is bankrupting them.

Reporting from Central FL.

Our organization is losing 2 million dollars/day due to much lower ED visits, primary care visits and low census. We lost 3 million dollars worth of cashflow per day. Attributing this to social distancing and local theme parks closed. We are having lower than expected Covid patients vs our projections. We are in talks of reducing staff hours from all over the hospital. Nurses are already flexed down.

 

[renim]

It is interesting to see how certain hot spot areas are just overwhelming the hospital system while in other areas Covid is bankrupting them.

Reporting from Central FL.

Our organization is losing 2 million dollars/day due to much lower ED visits, primary care visits and low census. We lost 3 million dollars worth of cashflow per day. Attributing this to social distancing and local theme parks closed. We are having lower than expected Covid patients vs our projections. We are in talks of reducing staff hours from all over the hospital. Nurses are already flexed down.

Similar in Australia
Australian hospitals to shut, 100,000 staff under threat

 

[MXLRplus]

Unintended consequences are going to be our worst problem.

Let's say C19 costs everybody 1 day. That's 22 million years. Assuming you have 80 usable years, that 274,000 human lifetimes per day lost.

 

[AlanSubie4Life]

I found the quote from the military in early March regarding the military risk. Who could have predicted this?

"Lots of immunizations." The "good immune system" theory of disease.

“Right now the overall broad impact to the uniformed U.S. military is very, very minimal. It’s not to say that it’s zero, but it’s very minimal, very few cases diagnosed, etc...That’s not surprising because we have a young demographic, healthy demographic, lots of immunizations, so on and so forth"

Exclusive: Captain of aircraft carrier with growing coronavirus outbreak pleads for help from Navy

And here's the text from the Captain of the Theodore Roosevelt, Brett Crozier, of Santa Rosa:

This captain seems to know what has to be done.

"Sailors do not need to die."

30 Mar 20
Subj: REQUEST FOR ASSISTANCE IN RESPONSE TO PANDEMIC

BLUF (Bottom Line Up Front): If required the USS THEODORE ROOSEVELT would embark all assigned Sailors, set
sail, and be ready to fight and beat any adversary that dares challenge the US or our allies. The
virus would certainly have an impact, but in combat we are willing to take certain risks that are
not acceptable in peacetime. However, we are not at war, and therefore cannot allow a single
Sailor to perish as a result of this pandemic unnecessarily. Decisive action is required now in
order to comply with CDC and NAVADMIN 083/20 guidance and prevent tragic outcomes.

1. Problem Statement. With the crew embarked, TR is unable to comply with CDC protocols or
NAVADMIN 083/20 guidance. Based on CDC guidelines and TR observations, the only
effective method to preserve an individual's health is total isolation for 14+ days in accordance
with the NAVADMIN Individual hotel/barracks rooms with separate heads). Due to a
warship's inherent limitations of space, we are not doing this. The spread of the disease is
ongoing and accelerating.

2. Inappropriate Focus on Testing. Testing has no direct influence on the spread of the COVID-
19 virus. It merely confirms the presence of the virus. Due to the close quarters required on a
warship and the current number of positive cases, every single Sailor, regardless of rank, on
board the TR must be considered "close contact" in accordance with the NAVADMIN. Testing
will only be useful as the ship returns to work after isolation or quarantine to confirm the
effectiveness of the quarantine period. Our focus now must be on quarantine and isolation in
strict compliance with CDC and NAVADMIN guidance.

The COVID-19 test cannot prove a Sailor does not have the virus; it can only prove that a Sailor
does. As an illustration, of the first 33 TR Sailors diagnosed with COVID-19, 21% (7 of those
33) infected Sailors were negative on a test, then subsequently presented with
of COVID-19 infection within 1-3 days post-test.

Based on data since first case, approximately 21% of the Sailors that tested negative and
are currently moving into group restricted movement ashore are currently infected, will develop
over the next several days, and will proceed to infect the remainder of their shore-
based restricted group.

3. Inappropriate Quarantine and Isolation. With the exceptions of a handful of senior officer
staterooms, none of the berthing onboard a warship is appropriate for quarantine or isolation.
Thousands of "close contact" Sailors require quarantine in accordance with guidance. TR has
begun to move personnel off ship into shore-based group restricted movement locations. Of the
off ship locations currently available, only one complies with the NAVADMIN guidance.
Infected Sailors reside in these off ship locations. Two Sailors have already tested positive in an
open bay gymnasium equipped with cots. Although marginally better than a warship, group
quarantine sites are not a solution and are not in accordance with current guidance.

In order to stop the spread of the virus, the CDC and the Navy and Marine Corps Public Health
Center both recommend individual quarantine. They both recommend against group quarantine.
They recommend limited or no contact with other exposed individuals and no use of the same
facilities or items exposed individuals have touched. NAVADMIN 083/20 echoes this guidance.

The environment most conducive to spread of the disease is the environment the crew of the TR
is in right now, both aboard ship and ashore:

a. Large amounts of Sailors in a confined space

b. Open, shared berthing

c. Shared restroom facilities

d. Confined, shared workspaces and computers

e. Shared messing for large numbers

f. Meals cooked / food provided by exposed personnel

g. Mandatory watch/operational tasks demanding consistent close contact (food
preparation, service cleaning, TFCC watches, unavoidable meetings to plan
execute COVID response actions, etc.)

h. Movement about the ship requires consistent close contact with other exposed
individuals (confined passageways, previously touched ladder railings/hatch
levers/door knobs etc.)

4. Ineffectiveness of Current Strategy: Based on current limitations (lack of appropriate
quarantine and isolation facilities, inability to effectively achieve social distancing), TR has
instituted limited measures to slow the spread of the disease. We have moved a small percentage
of the crew off ship, increased the frequency of thorough cleaning and attempted some social
distancing. The current strategy will only slow the Spread. The current plan in execution on TR
will not achieve virus eradication on any timeline.

5. Lessons Learned from the Diamond Princess: From an epidemiological research article on
the infection onboard Diamond Princess (the only comparable situation encountered
thus far) (Roklov et a1.) titled "Outbreak on the Diamond Princess cruise ship:
estimating the epidemic potential and effectiveness of public health countermeasures:"

"Cruise ships carry a large number of people in confined spaces with relative homogeneous
mixing. On 3 February, 2020, an outbreak of COVID-19 on cruise ship Diamond Princess was
reported following an index case on board around 21-25 January. By 4 February, public health
measures such as removal and isolation of ill passengers and quarantine of non-ill passengers
were implemented. By 20 February, 619 of 3,700 passengers and crew were tested
positive. We estimated that without any interventions within the time period of 21 January to 19
February, 2920 out of the 3700 would have been infected. Isolation and quarantine
therefore prevented 2307 cases. We showed that an early evacuation of all passengers on 3
February would have been associated with 76 infected persons." (As opposed to 619)

The final sentence of the abstract:

"Conclusions: The cruise ship conditions clearly amplified an already highly transmissible
disease. The public health measures prevented more than 2000 additional cases compared to no
interventions. However, evacuating all passengers and crew early on in the outbreak would have
prevented many more passengers and crew from infection."

The Diamond Princess was able to more effectively isolate people onboard than TR, due to a
much higher percentage of individualized and compartmentalized accommodations onboard for
paying customers. Their measures still allowed hundreds of people to become infected.
best-case results, given the current environment, are likely to be much worse.

6. Proposed New Strategy: There are two end states TR could achieve:

a. Maximize warfighting readiness and capacity as quickly as possible. No timeline
necessary. We go to war with the force we have and fight sick. We never achieve a COVID-free TR.
There will be losses to the virus.

b. Achieve a COVID-free TR. Requires strict adherence to CDC guidelines and a
methodical approach to achieve a clean ship. This requires immediate and decisive action. It
will take time and money.

As war is not imminent, we recommend pursuing the peace time end state.
TR has two primary goals in order to achieve that end state:

a. Prevent unnecessary deaths, reduce the number of Sailors that contract and
eliminate future virus spread.

b. Regain and maximize warfighting readiness and capacity as quickly as possible.

In order to achieve these goals, a clean ship is required. Every Sailor onboard must be
guaranteed virus-free and the ship environment must be disinfected. One infected Sailor
introduced to the ship will spread the virus. Off ship lodging in compliance with CDC and
NAVADMIN guidance is required for over 4,000 Sailors to achieve a clean ship and crew.

7. Conclusion. Decisive action is required. Removing the majority of personnel from a
deployed US. nuclear aircraft carrier and isolating them for two weeks may seem like an
extraordinary measure. A portion of the crew (approximately 10%) would have to stay aboard to
run the reactor plant, sanitize the ship, ensure security, and provide for contingency response to
emergencies. This is a necessary risk. It will enable the carrier and air wing to get back
underway as quickly as possible while ensuring the health and safety of our Sailors. Keeping
over 4,000 young men and women on board the TR is an unnecessary risk and breaks faith with
those Sailors entrusted to our care.

There are challenges associated with securing individualized lodging for our crew. This will
require a political solution but it is the right thing to do. We are not at war. Sailors do not need
to die. If we do not act now, we are failing to properly take care of our most trusted asset our
Sailors.

Request all available resources to find NAVADMIN and CDC compliant quarantine rooms for
my entire crew as soon as possible.


B. E. CROZIER

 

[Dr. J]

I'm sure, as this was super obviously going to be a huge problem in mid-January, that there were really smart competent people in the chain of command who were freaking out in January and wanted to do something. Unfortunately it requires leadership at the top in an organization like that.

This article from March 3 confirms that:

Pentagon chief warned overseas commanders not to surprise White House on coronavirus measures: report

Defense Secretary Mark Esper asked overseas military commanders to not to make any coronavirus-related decisions that could surprise the White House or contradict President Trump’s statements on the illness, The New York Times reported.

Esper gave the directive last week during a video teleconference call with U.S. combatant commanders based overseas, telling the military leaders that they should check back with the Pentagon before making any moves to help shield U.S. forces from COVID-19, defense officials told The Times.

And then later in the month, after cases mushroomed and it became a sh**-show, there apparently was a shift (this is from the previously cited Navy Times piece):

Many of the concerns raised by service members seem to spring from the military’s delegation of authority to lower echelons to make decisions for their units, an order that comes directly from the Secretary of Defense Mark Esper, who told reporters on March 24 that commanders and senior enlisted would have say over what measures get put in place.

This series of decisions negatively impacts force readiness and endangers lives. But it's reasonable to assume no one will be held accountable. (I hope I'm wrong about that.)

 

[FoverM]

It’s a _log_ scale
2 is 30%
4 is 60%
5 is 70%
Look at the y axis
More data is necessary

I've attached the csv file I used to create the graphs in Excel (with ".txt" appended to it for uploading).