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Steve

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13 hours ago, Simon said:

I live in a small(ish) rural town (population ~3200). We have at last check 18 cases in the county. Not so bad.  Yet.  We also have a hospital that is a glorified bandaid station (no ICU), an economy focused on the service industry (tourist destination), and a large retiree population (again, vacation town...some just chose to stay).
 

Even at only 18 cases, we haven't flattened things....they're actually looking to trend up as folks from the cities get uppity and start coming out again. And we would be devastated if it hit here in earnest.

The good news is that IL has a zoned plan for re-opening.  Once cases have trended downwards for two weeks in a given zone, they can be moved onto the next phase of re-opening...gradually relaxing restrictions.  If the cases start to trend up again, they move back to previous phases.  It makes sense...and it's rankling a large number of people that want to re-open everything right now.

 

This is what I find scariest about the "well, rural areas can reopen" theory.  One case in a town of 3,200 can be spread to a significant portion of the population before the problem is identified.  Then we have a hundred or more cases, and local heath care is overwhelmed.  Serious cases need to be transported a significant distance for treatment.

 

In Canada, the northern Territories are doing pretty well, but mainly because they closed down all travel with heavy, mandatory quarantine for those who absolutely HAD to travel, very early on.

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2 hours ago, Hugh Neilson said:

 

This is what I find scariest about the "well, rural areas can reopen" theory.  One case in a town of 3,200 can be spread to a significant portion of the population before the problem is identified.  Then we have a hundred or more cases, and local heath care is overwhelmed.  Serious cases need to be transported a significant distance for treatment.

Precisely. We have next to no ability to test -- all tests that are run locally need to be sent out to a lab (even though the hospital _does_ have the lab facility to run the tests in house, they're not allowed to do that)....which means that only those who call in for a test and are showing all the signs of having COVID-19 are getting tested.  So we effectively have no real notion of where we are in terms of infections....and a number of folks posing such ideas as having a flash mob bring tables and chairs and sit outside of the restaurants in town (which are providing curbside pickup) as a form of "protest"

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2 hours ago, Simon said:

Precisely. We have next to no ability to test -- all tests that are run locally need to be sent out to a lab (even though the hospital _does_ have the lab facility to run the tests in house, they're not allowed to do that)....which means that only those who call in for a test and are showing all the signs of having COVID-19 are getting tested.  So we effectively have no real notion of where we are in terms of infections....and a number of folks posing such ideas as having a flash mob bring tables and chairs and sit outside of the restaurants in town (which are providing curbside pickup) as a form of "protest"

 

That's an extremely good point.  It means the infected data from Rural areas is basically 'bad' to begin with.  Damn, I didn't think of that either.

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Editorial from Nature Biomedical Engineering

 

A fairly gloomy piece, advocating (on a scientific and experiential basis) large-scale and long-term population monitoring programs; some acknowledgement of the implications for personal privacy are made near the end.

 

Quote

The only plausible way to achieve herd immunity is through mass vaccination. This will take longer that many expect because the time needed to carefully test a vaccine (which requires regions with ongoing outbreaks) and to produce billions of doses of it (a risky early investment) cannot be massively shortened. Unfortunately, finding effective vaccines for COVID-19 is not a given. As with naturally acquired immunity to other coronaviruses, vaccine-induced immunity may be fleeting (lasting only a few months), partial (reducing the severity of symptoms) and population-dependent (elderly populations in particular may not generate sufficient levels of neutralizing antibodies or of memory B cells and T cells). Yet even if yearly vaccine doses are needed and only reduce disease severity, such a vaccine will allow the world to turn a corner.

 

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41 minutes ago, TrickstaPriest said:

 

That's an extremely good point.  It means the infected data from Rural areas is basically 'bad' to begin with.  Damn, I didn't think of that either.

 

The rule of thumb right now is that all data is bad.  Testing is inadequate everywhere.  Testing is more inadequate in some places than in others.  The tests themselves are inaccurate and expensive.  The dead are not tested.  The asymptomatic are not tested.  The obviously infected are not tested.  Some localities count suspected cases, others do not.  Some governments underreport on purpose.  Some governments deliberately discourage testing for fear of its effect on stock prices.  Some governments are actively engaged in disinformation campaigns.  People are dying and policy decisions must be made before all the facts are in.  It sucks.

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