Corona Part 3 - When Can We Reopen?

Lars Poulsen - 2020-05-19

Updated 2020-5-22

Corona 3 - When Can We Reopen?


Flattening the curve - Revisited

Back in early April, I wrote:

The "social distancing" protocols that have now been pretty uniformly adopted, aim to slow down the infection rate, so that it takes three or four days for the number of cases to double. That means that it takes a month to get from 1000 cases to a million cases, and by then, many of the early cases have healed, their hospital beds are freeing up, and an increasing percentage of the people they come in contact with have already healed and have immunity.

Under these circumstances, it may take 3 to 6 months for the infection to pass through the population, but there may be ICU beds and ventilators for most of the severely ill patients, at least in the wealthier countries, so the death toll will be much lower. Just how much lower depends on many factors that we do not yet know, but for the USA, it is projected to be between 100,000 and 250,000 - compared to 3 to 6 million without these precautions.

I also wrote:

If we had plentiful and reliable tests before the first infections, we could have done what South Korea and Iceland did: and release them only ofter the two-week incubation period expired, further directing everyone with symptoms to isolation hospitals.

If followed diligenty, these measures might maintain a situation where the virus is not circulating in the community.

All of that still makes sense. The prediction that by "social distancing" we might reduce fatalities by a factor of 20 has played out. While New York City (and its surrounding metro area including parts of Connecticut and New Jersey) was totally overwhelmed by the outbreak, they did eventually slow it down to where they had no more severe cases than their hospitals could manage, and nowhere else reached that level of near-collapse. Indeed, in most of the country, we have stayed at very low levels of infections (2-5%) except for a limited number of hot spots.

The Hot Spots

The hot spots are very well defined. Outbreaks grow rapidly ... The meat business has seen incredible consolidation. Most meat is supermarkets in the USA is processed by 4 companies: Cargill, Smithfield, Tyson, and JBS. One of the affected meat plants in Iowa is reported to produce 5% of all meat sold is US supermarkets. This creates high pressure to keep the plants open even when the workers are getting sick. Some of the plants have resisted testing of their workers, but when testing has happened, up to 80% of the workers were infected.

The Upside of Low Infection Rates

The upside of the low infection rates in many places is that these areas might be able to do what South Korea, Taiwan and Iceland were able to do from the outset (as described in the second quote at the top):

The problem is that in order to maintain a "clean" region, you have to have a fairly hard border and screen everyone coming in or passing through. This means roadblocks on the interstate highways, where we take everyone's temperature before they can continue, and everyone who "fails" the screening test is refused entry and/or sent to 2 weeks of quarantine. This is very hard to do in the USA.

The Downside of Low Infection Rates

The downside of the low infection rates is that the disease continues for a long time. I had predicted that with social distancing, it might take 3-6 months for the disease to work its way through the population. But here in Santa Barbara, we have suppressed infeactions to the point that it may take YEARS for that to happen. The assumption behind that prediction was that we could suppress the infecton rate just enough that we did not overwhelm the hospitals - and no more.

The Balance

NY Times' science and health report Donald McNeil says that managing this pandemic requires tht we go back and forth between "the hammer" (slowing down infection rates to protect the hospitals) and "the dance" of opening enough to maintain a working economy. I find that we are not "dancing" enough in my area.

At the present time, I would say that Southern Santa Barbara County where I live is clean enough that we could open most activities if they are compatible with keeping distance.

I do fear that if we open up, and word gets out in Los Angeles that Santa Barbara is open for business, our hotels will rapidly fill up with people from Los Angeles who might be less well behaved. I just do not see us getting away with putting a border checkpoint up on the 101 freeway at Rincon Beach.

The North half of our county has more cases than we here on the South Coast. Not only the Lompoc prisons, but also the city of Santa Maria. I suspect half of the Santa Maria cases are related to prison staff; the rest may reflect more low-income neighborhoods with more people per dwelling.

My Own Urges at This Time

I am ready to take more steps toward reopening than our local authorities are: All of this to be rolled back swiftly if we start to see hospitalization rates go up too much.

I think the requirements for "dancing out" are

Any time these are not met, we "bring down the hammer" again: Tighten restrictions again until we meet the qualifications.

Some things that we are not ready for yet:

Update Friday 2020-04-22

Today, the county tells us:
What businesses can reopen? The types of businesses now allowed to reopen in the latter phase of Stage 2 include dine-in restaurants (with modifications), schools and child care, retail stores, shopping malls, some offices, campgrounds, and RV parks. Higher risk businesses, such as hair and nail salons, gyms, churches, and hotels for non-essential stays, are not allowed to open until the Governor declares that eligible counties can move into Stage 3.
So no dentist, no haircuts.

Some sources:

[1] The Big 4 Meatpackers - Article from 2011; since then a Chinese company bought Smithfield

[2] Smithfield Foods: Wikipedia article

[3] JBS S.A.: Wikipedia article

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