Jul. 10th, 2020

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This is about the pandemic again. Move on now if you're sick of the topic.

Yes, I agree that there is no national strategy as directed by the White House (except "do everything possible to get the president reelected" of course, but let's just ignore that for the time being). There are still people in the public health sector, including the beleaguered CDC, trying very hard to formulate a national policy of some sort. But most of the public policy is actually being made at the state and city level, with some input from whichever part of the national approach is agreeable to the local point of view. And ultimately, every individual has to make their own decisions about their own actions. I've been paying very close attention to all of this, trying to sort through masses of vague platitudes and deliberate misinformation to find (1) actual data on the behavior of the virus and (2) some kind of  public health policy to support. I'm forming clearer and clearer theories about #1, but getting increasingly confused about #2. 

I know what my personal goal is. To avoid being infected long enough for a reasonably effective vaccine to become available, get myself and my family vaccinated, and then take my chances on it working. So for the time being, government guidelines and/or mandates have little effect on the decisions I make. New information on the behavior of the virus has and will. Currently, my family's approach is to do essential shopping only (in person, not by delivery app), avoid all indoor contact with people outside the household, but do a little bit of cautious socializing outdoors. We wear masks when we shop but not every time we step outside. I bike or walk during the day, always taking a mask along but only wearing it if I'm around other people for longer than fleetingly passing them on the street. Richard walks at night. I don't think he even bothers taking a mask, since there's not really anyone else on the street. Thorin seems to be following similar guidelines. None of this has changed as Minnesota has moved into different "phases" and I have largely lost track of what's open, closed, or restricted in various ways.

But I feel like I should at least follow what is happening at the city, state, and national level and formulate some kind of opinion on what policies are on the right track in terms of public health. I am increasingly confused on how to make any kind of judgments. What exactly are we (for any value of collective "we") trying to accomplish at this point?
  • KEEP THE VIRUS FROM OUR SHORES. It is far too late for the quarantine/trace/isolate strategy that was followed by New Zealand, China, and South Korea. So what is all this chatter about "contact tracing?" Contact tracing only works for stamping out small outbreaks in a population that is largely uninfected. It might POSSIBLY be of some help in New York City, where the main outbreak seems to have blown over and they are trying to open things up very very gradually. But when you're at the point where there is so much community spread that few people know where they were infected, what's the point? And when every attempt at contact tracing ends with something like, "And then I went to Mardi Gras" there is really nothing to be gained. 
  • FLATTEN THE CURVE: That's an achievable goal - accept the fact that most of the susceptible population is going to be infected eventually but keep the infection rate to the point where hospitals can handle it. I think that's what we were trying to do in Minnesota, and it has been successful. We do not have the lowest rate of overall infection, but we never reached the point where bodies were being stacked in the streets and people were being sent home to die. Our flattened curve is gradually rising now as younger people come out of hiding and start trading germs again, but it's showing no sign of spiking out of control. If that's the goal, we've met it. So I'm not sure why all the scowling and finger pointing at the young people infecting each other in the bars. It's going to happen eventually, and maybe now is the best time. 
  • OPEN THE SCHOOLS IN THE FALL: Politics aside, that is a worthy goal. Rather than turning the issue into the usual political football, maybe it's time for everybody to start concentrating on exactly what is the safest way to do that. It's about time that we accept the obvious evidence that the virus spreads like wildfire in enclosed, stale air and figure out how to ameliorate that. Instead of spending billions on useless plexiglass partitions, invest in equipment that increases the number of air exchanges in indoor spaces. Maybe spend some more and install UV and HEPA filtering. At the very least, OPEN THE FUCKING WINDOWS. European countries have had health standards for years requiring every public building to have windows that open. It's not an impossible feat, technologically or financially. Maybe states like California, Oregon and Washington that have mild climates year round could move some of their classes into outdoor tents. 
  • FIGURE OUT EXACTLY HOW THE VIRUS SPREADS and concentrate on risk reduction.  Pay no attention to the fucking WHO, which has its head up its collective ass. We've known for months that the virus is airborne and that indoor air is the main problem, not sneezes or surfaces or even crowded beaches. Instead of pretending that the virus can somehow be eliminated by sufficient amounts of hand washing, we need to figure out where people are actually getting sick and tell people what they actually need to know to decrease their  risk. This is the one clear benefit that I can see to contact tracing at this point, but we have to trace backwards as well as forwards. I really want to know if anybody has EVER been infected while grocery shopping. Or by touching a contaminated surface, for that matter. Why is that so hard to determine? 
Have I missed anything? What do you think the public health goals / priorities should be? 

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