The data is starting to come in and CNY is faring pretty well. Coupled with decreased population density, social distancing has been successful.
The local hospitals haven’t seen the numbers of patients that were projected by epidemiological models, nor have the seen figures near what I had even calculated. We never had exponential growth. Our 3 major hospitals combined have only rarely had more than 60 COVID-positive patients at any given time.
New antibody testing (now up to 15,000 tested statewide) reveals that far less than 3% of the CNY population has had COVID-19. Figures downstate are near 20%.
The fatality rate is not going to be as high as was initially feared, although the numbers will be difficult to ascertain with any certainty. There are certainly people who have expired early on who won’t be captured in the data.
Then again, this thing is also far more contagious than anyone initially expected as well. There will also be a far greater number of people who had the disease, were without symptoms, and will never be counted.
4 weeks ago, we had even less of an understanding. We had to stifle this coronavirus-thing as abruptly as possible while simultaneously figuring out what this thing was behaving and deeply it had penetrated the population. We are still without a perfect understanding, but we have a much better idea and we can start to make some decisions for our communities and our families, each with their own tolerances.
Me? I’m deciding when we will be ready to stop distancing in and out of the home.
First, there needs to be an acknowledgement that COVID is going to remain a low-level risk for the next year or longer. The risk of acquiring the infection is going to be inflated by selfish and irrational assholes who will avoid testing and self-isolation despite symptoms for fear of quarantine for themselves or their families. They won’t want to lose their income. They will put the rest of their communities at risk by doing so. Even when testing is abundantly available, there will people who won’t access it.
Meanwhile, society will continue to force those who have the virus – knowingly or unknowingly – to wear masks in public. No, they won’t prevent wearers from breathing in aerosolized virus, but it will mostly prevent the infected from spewing their nastiness into the air. Coupled with continued social distancing, this greatly reduces my family’s risk of acquiring the virus through respiration while out in the community.
Then, hand hygiene vigilance becomes imperative and – fortunately – the kids have been grilled with hand hygiene practices in the home since February. They are awesome. Between conditioned behaviors at home and the mask serving as a reminder to keep their hands away from their faces, they should have a greatly diminished risk of becoming ill by bringing dirty hands to their mouth, eyes, and nose.
But – more often than not – people will be responsible, or at least I hope. They will be able seek testing the minute they experience a fever, if for no other reason than a personal anxiety. NY is a couple of weeks away from having testing readily available throughout the community, at physician’s offices, urgent cares, and local pharmacies. NY is trying to hire tracers, so that when there is a positive finding, there can be a means of going back in and preventing further secondary spread.
In theory, such a strategy should be able to keep the virus’ R(0) at <1.0, which is manageable at a public health level, and NY can re-open in phases … my family can re-open one phase late while waiting to see what happens. We can afford to let other people be the guinea pigs. Then again, things won’t be that different for Christine and the kids for the foreseeable future.
Meanwhile – I am working in the field again. My risk of exposure is higher now than it has been in the last month. I am wearing a surgical mask when working with patients; I plan to ask them to wear a mask as well, even though most are homebound and are only visited by the occasional home health provider. I have always had borderline-OCD-level hygiene habits. For all practical purposes, I am not at a significantly greater risk working with an occasional patient (4-5/day) than I am with nearly any other interaction. And at least I get to screen the people that I am working with (again, acknowledging that they can always lie to me).
So, when do I kiss my wife again?
When do I hug my children?
How risk averse am I, or should I be?
Last week, I was thinking 3 weeks. In 3 weeks, CNY will have all the tracers it should need (plus some, to be honest). In 3 weeks, there should be a continued decline in hospitalizations as folks in senior settings who are positive are discovered and isolated. In 3 weeks, there should be abundant testing, allowing folks who present with symptoms to be tested more quickly and readily, isolating them from the community more urgently. If all that were to hold true, there wouldn’t be much more that I can hope for over the next year shy of a cure or vaccine, neither of which are around the corner.
But this week, some old concerns seem to have come to fruition. Yoiu see, on April 10th I had tried to go a local grocery store at 1400 and it was packed. I tried another, but it too had far too many autos in the parking lot for me to feel comfortable. Everyone seemed to be shopping for Easter, at once, with little precaution. I drove home and told Christine that – while I had seen great efforts to distance up until that time – I wouldn’t be surprised to see a bump in the positive cases a couple of weeks after the “beautiful” holiday. Well, I’ll be damned if Onondaga County hasn’t had a steady rise in confirmed cases (starting exactly 2 weeks after Easter) and it was just reported that today saw the largest single day tally of positive test results since the pandemic started with the highest number of cases acquired via community spread. Meanwhile, Madison County has more active cases today than at any other time since the pandemic began .
Folks let their guard down.
May 15th. All things being equal, I thought life at home would return to normal on May 15th.
All things haven’t been equal.
Now I need to see a steady and significant reduction in cases over the next 2 weeks to justify returning to a normal life, even if only inside the walls of my own home.