When will it be safe to resume normal activities?
People worldwide are isolating themselves to slow the coronavirus’ spread — sometimes voluntarily, sometimes under orders from government or public health officials. With travel restricted, many schools closed, group events canceled and workers telecommuting, many people are wondering how long these containment measures will last.
The answer is depressing: There’s no clear end point.
As the crisis nears pandemic status — there were nearly 114,000 COVID-19 cases worldwide as of Monday, including 130 in California — amid ominous signs that “community spread” is growing, there’s no looming breakthrough that could end the isolation tactics other than the development of a vaccine, which could take 12 months or longer.
In fact, the restrictions could get more draconian, with authorities imposing mandatory home quarantines, or isolating entire cities and regions, as China did for many cities. Italy on Monday announced a near-lockdown of the entire country.
The U.S. isn’t there, as of yet.
“I don’t think you want to have folks shutting down cities like in northern Italy,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said in an interview with the New York Times. “We are not at that level. That is a hot spot. Social distancing like in Seattle is the way to go. I’m not talking about locking down anything.”
Health officials haven’t developed protocols for when even the current steps should end — and that’s a problem, said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.
“If we pull the trigger to put them in place, then how do we unpull the trigger to take them off?” he asked. “We have got to figure out the long-term game plan before we embark.”
The federal government needs to address that soon, Osterholm said. “Telling a 65-year-old with underlying health problems to avoid large crowds and public events is very different” from large-scale closures. “That’s not putting entire industries at risk.”
He’s also worried about collateral damage to the health care system.
For instance, more than a third of hospital nurses have school-age children, Osterholm said. If schools close for prolonged periods, many of those nurses would have to stay home from work.
The level of containment will depend on how malignant the virus is in its spread and fatality rate, said Dr. John Swartzberg, clinical professor emeritus of infectious diseases and vaccinology at UC Berkeley. Those statistics are still evolving, he said.
One upbeat marker: China’s aggressive restrictions appear to have been effective. “They’re slowly allowing people to go back to work, children to school,” he said. “It’s been encouraging, suggesting the epidemic reached a peak in a month or five weeks, then started to level off.”
It’s still unknown whether this particular virus will wane in the spring and summer. Of the seven coronaviruses that cause human disease, four are seasonal, Dr. Swartzberg said.
Ending quarantine measures typically involves waiting some period of time to make sure there are no new cases, said Dr. George Rutherford, professor of epidemiology at UCSF. But deciding how long to wait is tricky.
The most conservative approach would be waiting two 14-day incubation periods with no new cases, “but that is probably way too conservative for the amount of disruption,” the isolation measures cause, he said. “Another way to do it is to (test) a lot of people to try to understand how much asymptomatic infection” exists.
Dr. Dan Diekema, director of infectious disease at the University of Iowa Medical Center, said the current measures won’t reduce the ultimate total volume of infections, but should keep new cases at a manageable pace.
The isolation measures are designed “primarily to space them out so that the numbers don’t overwhelm healthcare system capacity, (especially) the ability to care for the fraction of infected people who will require acute/ICU care,” he said in an email.
Some hospitals have discussed the potential for dire scenarios where they’d be forced to ration access to beds and ventilators if they see a surge in COVID-19 cases.
Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security, thinks the containment measures don’t make sense because of the virus’ characteristics. Instead of diverting resources to containment, public health agencies should have focused on preparing hospitals for cases and scaling up diagnostic testing, he said.
“A respiratory virus like this can’t be contained, especially when it has that much of a head start,” Adalja said. “It’s been spreading in China since at least November. It is spread efficiently from human to human. By the time it was even noticed in late December, who’s to say it hadn’t already spread all over the world and was mixed in with cold/flu season?”
In California, the decision to close, cancel or suspend public events, schools and universities has largely been left up to individual institutions, event planners and county health officials. As a result, counties are implementing a patchwork of closures and suspensions that vary greatly depending on what local health officials have decided is most appropriate, given the number of cases and evidence of community spread in their county.
San Francisco has banned “nonessential” gatherings of 50 people or more in city-owned buildings, including City Hall and the public library, until March 20. Santa Clara County on Monday announced a ban on events with more than 1,000 people until the end of March. The ban will take effect Wednesday and include events at stadiums, theaters, arenas and large conference rooms — where people are within arm’s length of each other in a confined space — but will not include airports, malls, public transit or offices.
The California Department of Public Health has issued guidance to event planners and school administrators on steps to take if COVID-19 has been reported in their communities, but has not made any closures or cancellations mandatory.
The agency, for instance, does not recommend that large public events be canceled in communities where COVID-19 cases have not been reported. In cases where students and staff at schools and universities have tested positive for the virus, the state says school administrators should consult with local public health officials to determine how long a school or campus should close.
The agency did not answer a question about if there are any circumstances under which the state would make school closures or event cancellations mandatory.
“This is an evolving situation, and state and county public health officials will alert the community as things change,” a department spokesperson said in an email.
Carolyn Said and Catherine Ho are San Francisco Chronicle staff writers. Email: csaid@sfchronicle.com, cho@sfchronicle.com Twitter: @csaid, @cat_ho
"tactic" - Google News
March 11, 2020 at 02:02AM
https://ift.tt/2wMPvKI
Coronavirus isolation tactics are ramping up in the Bay Area. When does it end? - San Francisco Chronicle
"tactic" - Google News
https://ift.tt/2NLbO9d
Shoes Man Tutorial
Pos News Update
Meme Update
Korean Entertainment News
Japan News Update
Bagikan Berita Ini
0 Response to "Coronavirus isolation tactics are ramping up in the Bay Area. When does it end? - San Francisco Chronicle"
Post a Comment