Anonymous wrote:South Korea is doing this right, testing a huge % of their population which allows for affected people to quarantine and slow the spread. I for the life of me can’t understand why we do not have the capacity to do this in the US.

Anonymous wrote:
It’s more complex than that. Automatically quarantining people without knowledge of the mode of transmission, and without considering the psychological and social effects, which impact on compliance, may be ineffective and it may be unwarranted.

The example of SARS and the attempt in Toronto to control it with mass quarantine - 100 people for every SARS case. It didn’t work in the case of SARS because it was being transmitted mostly at hospitals, not in the community, it was infectious only when the patient was clinically ill, and only about half the people complied. It was health care workers providing care for these patients, before PPE became standard, who were at risk. SARS led to the now mandatory practice of PPE in care facilities.

BUT, this is NOT to say that it shouldn’t be done for Coronavirus. All I’m saying that we should NOT jump to the conclusion that mass quarantine will stop an outbreak.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2094974/#B6

An outbreak should meet the following three criteria for quarantine to be a useful measure of disease control:

first, people likely to be incubating the infection must be efficiently and effectively identified;

second, those people must comply with the conditions of quarantine; and

third, the infectious disease in question must be transmissible in its presymptomatic or early symptomatic stages.

The use of quarantine in the Toronto outbreak failed on all three counts.

SARS quarantine in Toronto was both inefficient and ineffective. It was massive in scale. Toronto public health authorities quarantined approximately 100 people for each SARS case, while Beijing public health quarantined about 12 people for each SARS case. An analysis of the efficiency of quarantine in the Beijing outbreak conducted by the American Centers for Disease Control and Prevention concluded that quarantine could have been reduced by two-thirds (four people per SARS case), without compromising effectiveness if authorities had "focused only on persons who had contact with an actively ill SARS patient" (2).

- MD, MHS, but not an epidemiologist, who works with geriatric patients in Canada

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Honestly, how scared should I be right now? What is the likelihood that I will get this virus? What is the likelihood that I will die?

It's about distancing people from each other by quarantines and closures so that we can slow the rate of transmission down enough that hospitals won't be deluged in cases. If they are, seriously ill patients will die from lack of medical attention, like they're doing right now in northern Italy, and like they did in Wuhan. If hospitals don't have enough beds or personnel or equipment during the surge, people who shouldn't have died in the normal course of events WILL DIE from lack of adequate healthcare. It could be you or me, it will most likely be those who are most at-risk, as well as some unlucky healthy and younger patients who lie forgotten in some hospital corridor.

Virology explanation:
This is a new virus that just jumped the species barrier and as a result is not adapted to humans. Because of that it's more likely to kill its host or make it very ill, instead of living quietly and replicating. The consequence is that there is a characteristic spike in cases, like for all pandemics (that are all due to new strains maladapted to humans). THE SPIKE IS WHAT'S LETHAL TO THE COMMUNITY. Healthcare system are not made to receive so many patients at once, and they break down from over-solicitation. This will happen if we don't implement closures right now.

I hope you understand.

- microbiologist

It’s more complex than that. Automatically quarantining people without knowledge of the mode of transmission, and without considering the psychological and social effects, which impact on compliance, may be ineffective and it may be unwarranted.

The example of SARS and the attempt in Toronto to control it with mass quarantine - 100 people for every SARS case. It didn’t work in the case of SARS because it was being transmitted mostly at hospitals, not in the community, it was infectious only when the patient was clinically ill, and only about half the people complied. It was health care workers providing care for these patients, before PPE became standard, who were at risk. SARS led to the now mandatory practice of PPE in care facilities.

BUT, this is NOT to say that it shouldn’t be done for Coronavirus. All I’m saying that we should NOT jump to the conclusion that mass quarantine will stop an outbreak.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2094974/#B6

An outbreak should meet the following three criteria for quarantine to be a useful measure of disease control:

first, people likely to be incubating the infection must be efficiently and effectively identified;

second, those people must comply with the conditions of quarantine; and

third, the infectious disease in question must be transmissible in its presymptomatic or early symptomatic stages.

The use of quarantine in the Toronto outbreak failed on all three counts.

SARS quarantine in Toronto was both inefficient and ineffective. It was massive in scale. Toronto public health authorities quarantined approximately 100 people for each SARS case, while Beijing public health quarantined about 12 people for each SARS case. An analysis of the efficiency of quarantine in the Beijing outbreak conducted by the American Centers for Disease Control and Prevention concluded that quarantine could have been reduced by two-thirds (four people per SARS case), without compromising effectiveness if authorities had "focused only on persons who had contact with an actively ill SARS patient" (2).

- MD, MHS, but not an epidemiologist, who works with geriatric patients in Canada

I strongly disagree with your post, because closures and quarantines have been shown to prevent the inexorable increase in Covid-19 cases in other countries. We have OBSERVABLE, OBJECTIVE DATA that it works.
And I cannot stress this enough -
Closures and quarantines are our ONLY TOOL right now.

Your post dangerous, because as a health professional, you should have very clear, simple, direct messaging.
Close schools and workplaces. Quarantine patients and exposed people. Tracing their contacts. Disinfection of public places, washing hands.
Every measure other countries have implemented that have turned the epidemic around.

If you want to air your knowledge of SARS, great. But SARS is a different beast altogether in terms of propagation and mortality rate and as a doctor you should know that perfectly well and not muddy the waters for people who may not understand this.

Please do not post that closures and quarantines won't work for Covid-19. They have been shown to work. We will only save lives if we're all working together as a team.

Come on.

Anonymous wrote:Yet they are closing universities and going completely online. Just seems odd that they're not closing anything else.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Honestly, how scared should I be right now? What is the likelihood that I will get this virus? What is the likelihood that I will die?

High. You are stressing. This puts you in the highest risk
Just kidding. Depends how old are you, what other health issues do you have and how overworked and sleep depraved are you. All factors.
In theory 3.4 people die in. 100. In practice this changes up or down depending on the contributing factor.

If you are 22 female, non smoking, no known health issues, well rested and athletic, you are i n low risk group.

If you are a 69 male, smoker, overweight, with high blood pressure, congestive heart failure, diabetes and you drink to the point of liver damage, and your kidneys require dialysis, then stay home tape the door and pray.

This hasn't been how it is playing out in other countries. It sounds reasonable but it's not totally accurate.

Anonymous wrote:Harvard is going online March 23rd and asking students not to return after spring break.

It’s the smart thing to do otherwise they would have to deal with all those potential patients and quarantine

Anonymous wrote:

Anonymous wrote:There’s way more than 729. We all know that. If we had mass testing like South Korea we would be in the multiple thousands.

Thats the point.. once they testing started.. they are balooning.

Anonymous wrote:This isn’t SARS. It’s much more contagious. Quarantine is different from social distancing. Every single reputable public health expert is urging greater social distancin

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But if this is so, why the risk groups are NOT encouraged by the employers to work from home?

Anonymous wrote:CDC warns against long flights, but not short ones. Why?

Makes no sense to me.

Anonymous wrote:With all the MPH degree holders in this country you’d think we’d have a better handle in this situation. Sure don’t!!

Anonymous wrote:With all the MPH degree holders in this country you’d think we’d have a better handle in this situation. Sure don’t!!