A What Next Conversation
Social Isolation vs Cabin Fever
Peaks vs Second Waves and
Light Switches vs Dimmers
Governor Newsom and I think alike. I had just written the post below and the following article crossed my feed. I’m still interested in what you have to say. Gov Newsom specifics about reopening.
Much of the forward looking reporting that I’m reading and listening to right now seems to be focused on exiting sheltering in place. Part of me thinks that this is premature given the fact that the virus is still growing exponentially in the entire United States. (Yes we’ve slowed the growth but the epidemic is still growing.) However I too have cabin fever and I too daydream about what paths might lead to a more normal life.
What follows is an exploration of my current thinking. I would appreciate the thoughts of anyone who reads this post. Either attach in the comments interesting articles you’ve read about this topic or your own personal thoughts.
It Pays to be Pessimistic in a Pandemic: Second Waves of Infection
It seems like one of the big lessons from the 1918 Flu pandemic is that many regions experienced a second wave of infections. This second wave of infections occurred either because the weather turned colder and/or because the community let down their guard and let down their precautions. Here’s a great article in the San Francisco Chronicle describing exactly what befell San Francisco, San Francisco's 1918 Flu Debacle.
Any opening up or loosening of the social isolation rules needs to come with an understanding that as soon as the infection rate ticks up again we need to make the rules more strict.
Prerequisites: Extreme Ease of Testing, Some Sort of Treatment.
The testing for COVID-19 needs to improve greatly before we can open our society back up. As we open up new cases will occur and we’ll need to have the ability to easily track through testing the source of those new infections. (This is what should have been happening back in February.)
The medical establishment will probably need to have some sort of proven intervention that lessens the impact of COVID-19 making it less likely for infections to progress to hospitalization, to the ICU, and ultimately death.
Social Isolation as a Dimmer not a Light Switch
Much of the conversation about reversing shelter in place seems to assume that it will happen in an exact mirror image of the way it was imposed. (I.e. one day we’re not free to move as we please the next day we are.) This article Potential Long-Term Intervention Strategies for COVID-19 is one such example but I’ve run across others and many conversations seem to assume this. I think people forget that in the Bay Area enforcement got more and more strict. Furthermore with all of us traumatized to varying degrees we are unlikely to easily go back to our previous habits.
I see social isolation policies as being dimmable and adjustable to allow for more or less exposure. For example perhaps some groups would be allowed to go back to work before other or some areas would open up before other. Here are some ideas
Non-essential medical workers- dentists and other procedures that aren’t critical care.
Construction for all types of jobs.
Personal care, like hair stylists, with full protection for both the stylist and the customer.
Probably the last people are those of us who can do our jobs remotely.
Unfortunately there is likely to be competition among different social groups to be the first ones to have the freedom to operate. Also unfortunately if the opening up is too broad or aggressive because of this competition the epidemic will reassert itself and we’ll have to go back into more strict social isolation.
Different Age Groups Will Experience Opening Up Differently.
Because of their susceptibility to COVID-19, my parents’ experience of coming out of social isolation will be different to mine which will be different to a young adult’s. Specifically I imagine the older population will be much more cautious. If I was over 65 years old, I wouldn’t begin to let down my guard until the death rate of COVID-19 dropped for my age group. For myself I would like to see some proven medical intervention before I would start to let down my guard.
On the other hand a younger adult might decide that the challenges they face sheltering in place are worse than the low risks of contracting COVID-19. They might try to go back to work as soon as the shelter in place order is lifted.
And at the extreme end of this spectrum are those people who have had COVID-19 and are currently presumed to be immune.
What are your thoughts?
I am curious to know what standards you have for lifting the shelter in place order? What would you do if the shelter in place order was lifted? Have you read any good articles about the transition period?