It's good to see we're still stuck on all the same original arguments, that the actions taken in the initial days are the only actions and only goals. 
I think we can all agree on at least a couple of things:
Somewhere after that, opinions clearly begin to shift.
I would hope we all agree that the percent positivity is a measure of how well we know where the virus is circulating. Low values, under 1%, mean the community has a high degree of knowledge of where the virus is circulating. Large number, over 10% mean it's a huge unknown. Somewhere in the middle different opinions could be made, they're not absolute values.
We can break down the first item into parts:
Using the percent positivity, we can predict how likely the first is to occur. Which also means which techniques are possible for reducing it. At a high positivity, we've got no idea who is infected, so we try to stop all interactions of everyone. It's very blunt because we're basically blind. While when positivity is low, we can change to trying to isolate infected, eliminating the interaction in a targeted way.
For the "cross contamination", in the beginning we had no idea. Swab every surface, isolate packages for a days before touching, everything was suspect. But, we've learned more since then. We now know the largest risks are droplets. Along with there appears to be some aerosol risk. It doesn't look like the measles aerosol risk but it also cannot be ignored. This doesn't mean we can start licking random surfaces, but touching a cereal box isn't likely to be high risk. Activities with exposure to droplets and aerosols clearly increase the "cross contamination" risk.
The "long enough duration" and "large enough amount" tend to be related. A quick interaction with a small amount of cross contamination should be relatively low risk. But, increasing either is going to increase the risk, faster if you do both. Sing shoulder to shoulder with an infected person inside with lots of droplets and aerosols, even for very short time, not a great idea. Likewise, take a very long car ride in complete silence with no talking with an infected person and even the smaller breathing only droplets and aerosols is going to accumulate with the long duration.
The swiss cheese infographic the other day was nice. It hit all of these items with solutions that reduce, not eliminate, each of them for a larger cumulative impact.
The techniques and restrictions used to reduce each of these items will continue need to be broad wide ranging and not targeted as long as we have a high percent positivity. They're blunt tools working in the blind. Once positivity is under control and we know where community spread is occurring, more targeted and precise techniques can be used.
I think we can all agree on at least a couple of things:
Infection spreads when an infected person comes in contact with a non infected person for a long enough duration with enough cross contamination occurring that the non infected person receives a large enough amount to become infected.
Hospitals running out of capacity creates lots of problems.
Somewhere after that, opinions clearly begin to shift.
I would hope we all agree that the percent positivity is a measure of how well we know where the virus is circulating. Low values, under 1%, mean the community has a high degree of knowledge of where the virus is circulating. Large number, over 10% mean it's a huge unknown. Somewhere in the middle different opinions could be made, they're not absolute values.
We can break down the first item into parts:
- infected person comes in contact with a non infected person
- for a long enough duration
- with enough cross contamination occurring that
- the non infected person receives a large enough amount
Using the percent positivity, we can predict how likely the first is to occur. Which also means which techniques are possible for reducing it. At a high positivity, we've got no idea who is infected, so we try to stop all interactions of everyone. It's very blunt because we're basically blind. While when positivity is low, we can change to trying to isolate infected, eliminating the interaction in a targeted way.
For the "cross contamination", in the beginning we had no idea. Swab every surface, isolate packages for a days before touching, everything was suspect. But, we've learned more since then. We now know the largest risks are droplets. Along with there appears to be some aerosol risk. It doesn't look like the measles aerosol risk but it also cannot be ignored. This doesn't mean we can start licking random surfaces, but touching a cereal box isn't likely to be high risk. Activities with exposure to droplets and aerosols clearly increase the "cross contamination" risk.
The "long enough duration" and "large enough amount" tend to be related. A quick interaction with a small amount of cross contamination should be relatively low risk. But, increasing either is going to increase the risk, faster if you do both. Sing shoulder to shoulder with an infected person inside with lots of droplets and aerosols, even for very short time, not a great idea. Likewise, take a very long car ride in complete silence with no talking with an infected person and even the smaller breathing only droplets and aerosols is going to accumulate with the long duration.
The swiss cheese infographic the other day was nice. It hit all of these items with solutions that reduce, not eliminate, each of them for a larger cumulative impact.
The techniques and restrictions used to reduce each of these items will continue need to be broad wide ranging and not targeted as long as we have a high percent positivity. They're blunt tools working in the blind. Once positivity is under control and we know where community spread is occurring, more targeted and precise techniques can be used.
