What does re-opening look like?

Zemgirl

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Israel is in good shape, a lot of restrictions have been lifted, and I wasn't planning on staying mostly home until there was a vaccine. With all that said... these people are idiots, or jerks, or both:
FWIW I also blame our government for enacting some truly nonsensical restrictions earlier, and for not doing much to alleviate the economic impact on large parts of society. They lost people's trust and compliance, and I really hope we won't end up paying for it down the line.
 

Dobre

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With regards to the "Go out, trust me once. They won't believe you a second time" quote, I have a few thoughts:

1. I feel like it would help if places set criteria for what might lead to another shut down and/or rollback to a higher restriction level. (You know, the way we have different threat levels for forest fires and we know when there needs to be a burn ban in place versus when it is OK to ease restrictions). Here, for example, all counties had to apply to reopen. I worry that once you open (which does need to happen), it will be harder to convince people to close anything again. That there may be more flack and/or that leaders may be too afraid to pull on the reins until too late. Whereas, I think, if you set your criteria clearly up front. (For example, this is where you need to be on new case numbers, hospitalization percentages, etc.) Then you might see counties watching that criteria carefully themselves and rallying themselves in the hope of not being shut down or slowed down by the state in the future.

I can see a few arguments against this idea; but in general, clear goals and clear consequences often work.

2. We are learning. Each day we learn something new and while those lessons are often grim, they are also not a step back. Doctors, of course have needed this time to learn methods of providing care for patients. But also we have needed this time to learn where some of the weaknesses in our most basic services are and what types of responses can work. We are undoubtedly going to go through the same process with other types of services. And we are going to learn how difficult it is to track people engaging in some of them. We may learn that some of our current tracking & tracing methods are inadequate, and we may learn that some are impractical or aimed in the wrong direction. But we are moving forward as long as we learn from experiences.

3. There are a lot of countries tackling this challenge now, and while each is different & faces different values/priorities/logistics, we have seen many cases of where when something works, that becomes the accepted practice on a widespread level. Someone always has to be first, and that is a scary place to be but it also doesn't always have to be the same someone. We share that challenge with the whole world.

4. Because of the fact that we are learning, I am not certain that people will not try again as the quote above implies. One of my greatest concerns is that things will not shut down quickly enough if a threat surfaces. If that is proven unfounded--if places respond promptly and outbreaks are not allowed to turn into hotspots--then I think I will feel better about returning to work. Also if some people learn that they need to take further precautions, that is probably because they really need to take further precautions. Not that they need to disengage from the economy but that they need to learn how to engage in this new economy.

(And it's a worldwide economy. All this talk as though Sweden and/or the U.S. and/or any other country is out there determining its own independent economic future is so clearly not reality. Everything from nurses to masks to exercise bikes to the parts that go inside the exercise bikes to oil to roller blades to pork to eggs to yeast to grain to mills to toilet paper to tech helpline services to migrant labor--they all impact people all over the world).
 
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MacMadame

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I've heard/read that 2-3 weeks is not enough time. I've heard that it'll take 6 weeks until we know the effects of opening up. (Mixture of German and US sources).
People say all sorts of things. :)

In this case, it was our Public Heath officer saying she wants 2-3 weeks so it's not my opinion, it's hers. And I'm okay with it. I'd even be okay with a month but 6 weeks seems a bit much for a disease with an average incubation period of 5 days. (Yes it can be as much as 14 days but that's not typical from what I've read.)

Whereas, I think, if you set your criteria clearly up front. (For example, this is where you need to be on new case numbers, hospitalization percentages, etc.) Then you might see counties watching that criteria carefully themselves and rallying themselves in the hope of not being shut down or slowed down by the state in the future.
Most places opening up have Stages with different criteria for moving between them. Now some places have vague criteria but a lot are pretty specific.
 

ballettmaus

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People say all sorts of things. :)

In this case, it was our Public Heath officer saying she wants 2-3 weeks so it's not my opinion, it's hers.
I didn't think it was yours. :) They're doing the same in Germany, so I'm under the impression that the government is doing things a bit differently than scientists would. Scientists may be going for the maximum while governments are going for the minimum or middle? (As in, yes, you can see effects after 2-3 weeks but it's better to wait 6).


And I'm okay with it. I'd even be okay with a month but 6 weeks seems a bit much for a disease with an average incubation period of 5 days. (Yes it can be as much as 14 days but that's not typical from what I've read.)
I thought 6 weeks was a long time, too, for the same reason. But scientists/health experts seem to agree.
The Atlantic refers to an Obama administration health official here: https://tinyurl.com/yc8mlc9c

CNN quotes a data scientists who made a model used by the CDC: https://tinyurl.com/y7b7qzfc

And someone from Johns Hopkins says the same: https://tinyurl.com/y9j72o2y

I can't find the German news report that I heard, so I don't know who it said in Germany or why. But in the US, they all seem to be saying that it's due to the illness' slow progression. Maybe their definition of "we'll see the effects" differs from what we think? I don't know. 🤷‍♀️ I guess, time will tell. But it would be great if it weren't that long because the sooner we'll see what happens, the sooner governments can react accordingly.
 

MacMadame

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They're doing the same in Germany, so I'm under the impression that the government is doing things a bit differently than scientists would. Scientists may be going for the maximum while governments are going for the minimum or middle? (As in, yes, you can see effects after 2-3 weeks but it's better to wait 6).
I think a public health officer is not a politician though.

I could only read two of those stories but I didn't interpret them as scientists are saying 5-6 weeks and politicians aren't accepting that. Many of the scientists quoted in the stories didn't give a hard number at all, just saying it will be "a while." Others were pointing out that there is always a lag in the numbers but not giving a hard timeframe.

Only Trump was quoted as saying "that's not acceptable." And only 1 says 5-6 weeks.

In the end, it depends on what the goal is. My goal was always to avoid another Italy and NY where hospitals were overrun and healthcare workers were getting sick and dying due to inadequate PPE while having to decide who lives and who dies and committing suicide because they are put into a hopeless situation where they can't do their jobs.

I don't think my county is on that path and the small amount of loosening up we did is not going to put us there.
 

Dobre

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Most places opening up have Stages with different criteria for moving between them. Now some places have vague criteria but a lot are pretty specific.
Alrighty, so you know how if you ask a question on FSU, some kind person will write an article about it, well voila here is Oregon's criteria (if you scroll down far enough there is a little chart with green checks & red x's. We have 18 counties meeting the criteria they are supposed to meet and the rest not. (Especially, it appears not meeting the below 30% of new cases without a known origin criteria).

https://tinyurl.com/yclmf3cb

And here is the actual dashboard with all the counties' results:
https://tinyurl.com/yagdcjtt

But there are no clear guidelines on when counties would lose their status in the current stage or be halted from moving on to the next. The article does say that public health authorities "plan to monitor progress and offer support to counties." Which sounds like a good thing . . .

*(Personal grumble that Umatilla County is not-surprisingly still trending upward, & I still think they had no business being approved for Stage 1. They were "reviewed" but still approved).
 

Louis

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Not sure if this belongs here or in the vaccine thread, but here's an article from a leading scientist explaining all the challenges to a vaccine, and why one is from certain:

A top U.S. scientist behind groundbreaking research in cancer and HIV/AIDS warned that a vaccine for the ******** may never be found as the number of global *********-19 infections surged past 5 million Thursday.

The scientist, William Haseltine, who has also worked on human genome projects, said that while a *********-19 vaccine could be developed, "I wouldn't count on it." Instead, he told Reuters, countries that are beginning to reverse lockdown measures need to lean on careful tracing of infections and strict isolation measures to control the spread.
Haseltine cautioned that vaccines developed for other types of ******** in the past failed to protect mucous membranes in the nose, where the ***** typically enters the body. And while tests of some experimental *********-19 vaccines on animals were able to reduce the viral load in organs like the lungs, the infections remained.

Haseltine said that even without an effective treatment or vaccine, the ***** can be controlled by identifying infections and finding and isolating people who have been exposed. People should also wear masks, wash their hands, clean surfaces and keep a distance, he said.
I'm way out of my league here, but this doesn't sound to me like a vaccine is anything close to guaranteed or we can put any kind of timetable on it.
 

Miezekatze

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I think even if no vaccine was found, I'd guess medications and treatments will improve, which would also be a means to get the ***** under control.

I think the original idea here once was to use this method of opening up things one by one and then wait 2 or 3 weeks to see the effects, but I think practically that's not what it being done in germany, I think the actual plan is more to gradually open up things relatively quickly after each other, with quite some things at the same time, but have a regional warning system in place per town or per small region (many towns now use warning systems were several warning indicators first turn yellow and then red and at yellow first measures have to be taken and at red a local re shutdown would happen).

I think the downside of this is that regionally everything would have to shut down again if numbers rise.

I think the problem with the original idea is, that it would take ages until some businesses or types of activities would get to try to open up (because the countries would still be waiting on what the effects of the first things that opened were) and it might not even be that they are actually more dangerous than others. I think what we're doing now is somewhat more practical and also more fair.

Because with the original idea, it might go something like:
  • First we'll open up restaurants and shops and then we'll wait 2 or 3 weeks and then if nothing goes wrong, we'll allow people to play tennis and golf and open first hotels and then after 2 or 3 more weeks, we'll let fitness studios and zoos oopen, ...with that timeline it might turn out this works, but all the zoos are broke, because it took 1,5 months until they could open even if nothing went wrong at all. I think that idea only works theoretically
  • Opening more things in a shorter time frame (of course it's still not everything opening up at once, but the waiting time is not so long and more things are opening parallely) might pose less control, but I think they can still work out what things are the most problematic in terms of infections, because you'll still always be able to track where the infections occurred and which things are the most risky and dangerous.
 
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skategal

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What I am hearing from the public health peeps here is that 28 days is the gold standard for moving between phases.

IIRC, they based that on the WHO recommendations.
 

Zemgirl

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I think the original idea here once was to use this method of opening up things one by one and then wait 2 or 3 weeks to see the effects, but I think practically that's not what it being done in germany, I think the actual plan is more to gradually open up things relatively quickly after each other, with quite some things at the same time, but have a regional warning system in place per town or per small region (many towns now use warning systems were several warning indicators first turn yellow and then red and at yellow first measures have to be taken and at red a local re shutdown would happen).
That's been the case here as well. As soon as things started opening, people began clamoring for the next set of restrictions to be lifted. On top of that, the lifting of restrictions began April 19 really took off in May, and so far there has been no increase in cases and the number of serious cases has dropped. There are fewer tests being done due to lack of demand. It's hard to convince people to play it safe given all this, and I'd say that at this point the decision-makers aren't making decisions so much as being led by the public doing it for them.

It will be very difficult to shut everything down again, but shutdowns in specific places might still be doable.
 

becca

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My understanding is part of Sweden’s calculations was they wanted restrictions that were long term sustainable.
 

Aceon6

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I haven't needed to buy gas since late February. Apparently, a bunch of my neighbors were in a similar situation. All 12 pumps were in use today. No problems, everyone respectful of social distancing.
 

once_upon

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The thing that struck me in the state news briefing, besides the cases doubling and hospitals occupancy at 70% in my county was the state Public Health director said he's talked to the CEO of the hospitals who "can" expand capacity but staffing is a concern with currently overtime hours.

And as a nurse knowing that May, June and July you have recent graduates who need more assistance from the seasoned staff. Making staffing stressed.

So we open bars, sports, venues, zoos.
 

sk8pics

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I have an appointment at the dentist next Wednesday. I had originally been scheduled for April, and then rescheduled to June, but then they had an earlier opening. They are a really good office, so hopefully they are not scheduling too many people at once. But if they are, I will just wait outside instead of in the waiting room.
 

once_upon

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Non contact or low contact sports in Nebraska can start June 1 and games June 18. Those are defined by AAP.

No football, soccer, basketball and one other I can't remember, will be reassessed to see a new DHM will allow at the end of June.

From county update:

No portapotty at parks this year. If permanent toilets exist in parks they will be cleaned/sanitized every 24 hours.

The cases are 50% community acquired, 50% from packing plants, nursing homes or known clusters. Deaths with comorbidities highest one is diabetes, second lung issues (COPD, asthma).

Public health director for county emphasizes need to follow precautions masks, handwashing, social distancing. We need to remember that if we dont take precautions we will see much higher numbers.
 

MacMadame

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But there are no clear guidelines on when counties would lose their status in the current stage or be halted from moving on to the next.
I would assume it would work like @Firedancer said vvvvvv

NYS also has a dashboard showing which regions meet the criteria to open. My understanding is these seven metrics will be monitored and if a region falls out of compliance with one or more they have to stop reopening. https://forward.ny.gov/regional-monitoring-dashboard
 

Dobre

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Stop from moving on to the next phase? There's nothing about that mentioned in the article I read so I guess if that is the case here, I would like to hear it. Before we get to counties complaining about not being able to move on. Also, I am curious how long one would need to meet the required criteria before being able to move on. (Only one week? Two weeks? Several?)
 

MacMadame

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Also, I am curious how long one would need to meet the required criteria before being able to move on. (Only one week? Two weeks? Several?)
The criteria includes this information. For example, for our criteria some of it has a timeframe and some doesn't.

I'm not understanding your confusion. Each stage has criteria. If a county doesn't meet the criteria for a stage, they can't move into it by definition. And if they move into it and stop meeting that criteria, they have to move out of it. That's what the criteria exists for -- to say who can be in what stage.
 
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OMG, massive lineups outside the Winners!!!
Here too. Except they’re in the process of moving to a new location so they aren’t re-opening. But they had a sign on the door that said they would be open today and it said online it would be open. People were mad, and it sounded like a total gong show. Hell hath no fury like a bunch of women and a couple of men told they can’t browse discount clothes and home goods!
 

overedge

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Winners sells shite anyway. If I'm going to get the v*r*s from going to a store, I'd sooner get it at IKEA.
 

Miezekatze

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Today, a first infection herd from a restaurant visit after reopening was reported in Germany, 7 infections in one restaurant, leading to 50 contact persons in quarantine. No information whether the hygiene and social distance rules were obeyed at the restaurant.

Plus our state governor saying that there might no Christmas markets or carnival this year (runs from November 2020 to March 2021).
 

ballettmaus

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I could only read two of those stories but I didn't interpret them as scientists are saying 5-6 weeks and politicians aren't accepting that. Many of the scientists quoted in the stories didn't give a hard number at all, just saying it will be "a while."
I consider "a while" and "several weeks" to mean more than 2-3. But like I said, I guess, time will tell how quickly we'll see the effects :)

But I didn't mean that I believe politicians aren't accepting what scientists say. Obviously, governors have a different objective than scientists and they have more data than health data to consider. I think that if governors are told by their advisors that there'll be an indication after 2-3 weeks but not entirely reliable data, then they'll go with the indication because they still have all those other things to consider. I guess, you could say they don't have the luxury of just going by the scientific standard.
And if Thing A opens and two weeks later Thing B opens and there's an outbreak/cluster 7-8 weeks after Thing A open, it's still possible to determine that it likely came from Thing B.
 

MacMadame

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And if Thing A opens and two weeks later Thing B opens and there's an outbreak/cluster 7-8 weeks after Thing A open, it's still possible to determine that it likely came from Thing B.
That's true!


I do not understand this mad rush to open dine-in restaurants btw. That and houses of worship. These activities are high-risk by any standard. The only thing higher would be workplaces and places with hundreds of people like a fair or concert.

Obviously, you can mitigate some of the risks with social distancing and being outdoors. But anywhere you sit indoors for an hour at a time while talking with people you don't live with should be what CA calls Stage 3 (high-risk that you can do with mitigations vs. high risk that requires treatments and/or vaccine which is Stage 4). Restaurants in particular are places where the customers can't really wear masks most of the time.
 

becca

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That's true!


I do not understand this mad rush to open dine-in restaurants btw. That and houses of worship. These activities are high-risk by any standard. The only thing higher would be workplaces and places with hundreds of people like a fair or concert.

Obviously, you can mitigate some of the risks with social distancing and being outdoors. But anywhere you sit indoors for an hour at a time while talking with people you don't live with should be what CA calls Stage 3 (high-risk that you can do with mitigations vs. high risk that requires treatments and/or vaccine which is Stage 4). Restaurants in particular are places where the customers can't really wear masks most of the time.
I know for Mass the rules are everyone not in same household sits 6 feet a part and masks are required to be on accept for communion plus no sign of peace etc.
 

Dobre

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I'm not understanding your confusion. Each stage has criteria. If a county doesn't meet the criteria for a stage, they can't move into it by definition. And if they move into it and stop meeting that criteria, they have to move out of it. That's what the criteria exists for -- to say who can be in what stage.
So you are saying that all the criteria listed on the graph I posted before is criteria for entering Stage 2. And once there are counties that enter Stage 2, those counties will then have a new set of criteria they need to meet. Correct?
 

ballettmaus

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I do not understand this mad rush to open dine-in restaurants btw. That and houses of worship. These activities are high-risk by any standard. The only thing higher would be workplaces and places with hundreds of people like a fair or concert.
Also, don't people of faith tell you that you can pray anywhere and don't need a church to do so?

I get that it's a place to socialize but at the moment, you shouldn't socialize (afterwards) anyway.


My mom spoke to a former colleague in Berlin today. Children are kept in groups of 10 and they can't switch groups. Children from essential workers stay in their group, kindergarten-aged children who can go back now, get their group, then when pre-school children go back, they get their group etc. They've got assigned times when to go outside and play and they can't leave the kindergarten/pre-school grounds. (Which makes sense in some cases but this particular pre-school/kindergarten is close to the woods and each team used to go into the woods once per week and in summer, they used to spend a whole week in the woods. They even had lunch there. I think it makes little sense not to allow that under the circumstances. What could be better for the kids than to be outside in a group of ten, somewhere, where no one else is?)

Children from essential workers can be there for up to eight hours, all other children only get four hours. That's not a protective measure but due to the fact that Berlin's kindergartens and pre-schools are notoriously understaffed, so if all children got to be there for eight hours, they wouldn't have enough teachers. My mom's former colleague isn't sure how long they'll be able to do the 10 kids per group. She thinks they'll run out of teachers soon.
Also, during the last hour, all children are outside together. Neither children nor teachers are required to wear masks but parents can't set foot onto the grounds without wearing a mask. ( :huh: ) And she didn't mention a health check of any kind.
 

SkateSand

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The national park closest to my house is opening on May 29th, including the main campground and the highway through the park. I see a picnic lunch and a hike around a lake in our near future. :)
 

MacMadame

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So you are saying that all the criteria listed on the graph I posted before is criteria for entering Stage 2. And once there are counties that enter Stage 2, those counties will then have a new set of criteria they need to meet. C
Yes. To get to the next stage, they have to meet the Stage 3 criteria. And if they are in Stage 2 and they stop meeting the criteria for Stage 2, they are supposed to drop back to Stage 1.

I know that CA (and other places) will enforce this (to best of their ability) but I am equally sure that some places will not. (Georgia anyone?)

Also, during the last hour, all children are outside together.
Thus undoing everything they've spent all day avoiding?? Or am I missing something.
 
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