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DRAFT FOR A TOTAL SHUTDOWN, 15 DAYS

image45

BY DOUG TERRY, VETERAN REPORTER, WRITER,

SOCIAL ANALYST 


This is a draft of a plan to defeat the novel Coronavirus, to stop it

in its tracks.

There is likely no single plan that can do the trick, but, having

investigated the best ideas of epidemiologist and virologists, this is

intended as the start of plan provided the best minds in science

indicate its potential viability and, at the same time, modify it to meet

the conditions at the time of implementation.

First off, the premise is that the start made around March of 2020,

while working in some areas, is not working in others. This is due to

resistance by governors, the lack of a clear direction on the national

level, the resistance of the public and, importantly, the lack of a

concerted campaign of public education. (All of these issues will be

addressed here in turn, when appropriate.)

The original plan was worked out in the bowels of government during

the administration of G.W. Bush. It could be considered a “catch all”

plan rather than one tailored to this particular emergency.

Furthermore, the outlines of its recommendations for action might

have been limited by the perception of what could be done, what could

be asked of the public.

It is time to move past the perceptual limitations of public and

governmental cooperation and move to WHAT MUST BE DONE to

defeat the virus. This is the purpose of this outline.

Some elements of the pandemic virus are known, others lie between

known and presumed, awaiting scientific proof.

We know the following:

1. The point of infection to the appearance of symptoms, most

people go five days without becoming seriously ill. This can be

viewed as a kind of gestation period, a time when the virus is

taking root in the body, reading to do its damage.

2. We know about 40% of those who are infected never show any

symptoms. It is believed that people who are asymptomatic

can infect others, but this has been a subject of controversy.

The safe conclusion is to act as though they can transmit

infection, provided a means can be found to reduce the

probability.

3.  From Harvard Medical School:

People are thought to be most contagious early in the course of their illness, 

when they are beginning to experience symptoms, especially if they are coughing and sneezing. But people with no symptoms can also spread the coronavirus to other people 

if they stand too close to them. In fact, people who are infected may be more likely to spread the illness if they are asymptomatic, or in the days before they develop symptoms, 

because they are less likely to be isolating or adopting behaviors designed to prevent spread. We know that transmission mainly occurs person to person either by close 

personal contact when breathing or with the second person coming into 

contact with larger droplets expelled by singing, yelling, coughing, sneezing or 

other expulsive verbal or non-verbal mouth and throat actions.

4. We know that transmission mainly occurs person to person

either by close personal contact when breathing or with the

second person coming into contact with larger droplets

expelled by singing, yelling, coughing, sneezing or other

expulsive verbal or non-verbal mouth and throat actions.

5. We know that indoor spaces without adequate ventilation are

ripe for virus transmission. We also know that the issue of

ventilation has been somewhat ignored in the battle and the

concept of “adequate” has not been carefully or widely defined.

Do central building air conditioning/heating systems capture

enough viral droplets to reduce or stop transmission? The

likely answer is no.

6. We know that testing, with its current delays, is almost totally

useless from a public health standpoint, only providing a

delayed yes/no outcome for the person who gets the test,

someone who might be deathly ill by the time the results or

available or who might have infected others while waiting.


Here is the beginning of a plan to address all of these issues:


We should consider a national or regional hard shutdown of 15 days.

This could first be implemented in the states that, at the time, have the

highest number of increasing cases and deaths.


What would a hard shutdown involve? Close everything, including

supermarkets, any gas station that cannot operate by credit cards


alone, all restaurants, all stores, even grocery stores. Only police, fire

and hospitals other identified emergency services would remain open

and, to the extent possible, with reduced staffs. Electrical power and

water would still be required, of course, but these could be provided

with minimum personnel and minimal interaction with the public.


One month or so before the hard shutdown, people would be advised

to get ready, to buy food, medicine and anything else they need.

Special provisions would need to be made of those who need

constant in home or nursing home care, again always looking to the

minimum required. Home nurses, for example, would be encouraged

to stay in the home where they work for this period.


In cities, such as New York, where thousands depend on public

transpiration daily, special arrangements would be required. It could

be a fleet of buses, with isolation capacity, would be put into service.

Since hospitals would remain open, those who must travel to their

work could anticipate their needs in advance and communicate them

to transit authorities. Some people, where necessary, could be housed

in hotels, again with minimal staffs and no regular room cleaning or

service.


MASKS


The issue of protective masks needs to be re-examined. Is it possible

to get better masks to those who would have to be out and about

during the shutdown, masks that protect the wearer as well as those

with whom she might come into contact? Mask strategy, instead of

relying on everyone to go their own way, would have to be part of the

plan. How a mask should be worn and what type of mask is best

would be part of an educational effort.


POSITIVE RESULTS:


This 15 day hard shutdown would have good effects in that random

public spread would be halted, for the most part. In places where

people are crowded into small apartments or other tight spaces,

unfortunately, person to person spread would continue. This is an

issue that needs further examination and a plan toward resolution. In

New York State, as infections began to fall during its shutdown,

indications were the 60% of new infections were taking place inside

residences.


TESTING

To be most effective, a 15 day plan needs to take place once rapid

tests are available, most favorably tests the individual could do at

home. If something like universal testing could place, we could be

assured that very few infected, transmitting people were going back

into public spaces.

The only other option for testing, barring rapid home tests, would be

the idea of pool testing whereby people were tested as a group to

determine if they needed individual testing. This kind of testing, on a

mass basis, seems very difficult to implement but should not be ruled

out. During the 15 day shutdown, those who were going to get sick

from the virus would be self identified by their illness. If 90% of the

public were to wear masks at the end of the shutdown, we should see

good results rapidly.


Returning to work could be done over, perhaps, a one week period with

alphabetical order used to determine the exact day. This would allow testing

of at least a high percentage of those going back to ordinary life.


One tremendous problem for businesses, individuals and families with

the indefinite shutdowns that took place largely on the east coast from

mid-March onward is the fact that no one had any idea when the all

clear would be sounded. How do you plan your budget for a family or

a business when you have no idea when your income will resume?

The answer is you don’t. Desperation sets in and people start to

wonder if the cure is worse than the disease.


A 15 day shutdown would be finite and most normal activities could resume at

the end, excluding super spreading events, like parties and gatherings in bars,

for an addition 15 days.


PROBLEMS WITH THE PLANS AS THEY EMERGED


For one thing, few scientists stopped to consider the needs of ordinary

life. Millions of people have little or no savings and rely on paychecks

to pay for vital needs, like rent, mortgages and food. The actions of

the federal government helped, but they were not closely tuned to the

way people live and their immediate needs.

Having a plan for a finite shutdown that would likely occur in the fall,

2020, the programs to provide support could be better organized. For

example, a mass distribution of a food stamp type program could

occur before the shutdown began. Likewise, cash distribution to cover

the period could take place in advance.


All of this would have to be carefully planned, point by point. It is

estimated that 20% of the population has some form of disability. The

means of getting groceries and food to this population would be a

central concern and some way to respond to emergency shortages

would have to be devised.


For most people, putting in two weeks of provisions for food, with cash

or other payment in hand, would not be a major problem as long as

money is available. Of course, millions don’t have extra money. What

they get in their paychecks is dedicated to immediate needs ahead, so

there is a need for supplemental income in advance.


A public education campaign would have to be conducted on this

issue as well. Some means of getting emergency food to those who


were not able to plan ahead would have to be implemented, perhaps

by having police officers or firemen directly deliver food when called.

This plan will work best when it is thought of as a near complete

shutdown for two weeks and a day. People would be encouraged, of

course, to continue outdoor activities, getting exercise, taking long

walks and biking. No one other than those who are proven to be ill

would be confined to their houses or apartments.

Here is the outline for the beginning of a plan that would be carefully

reviewed by virologists, epidemiologists, scientists and public health

officials:


1. A 15 day maximum shutdown is planned for the US with about

30 days notice (45 if possible)

2. Everything is closed commercially, including grocery stores,

schools, all businesses. There is no division, in the main, between

essential and non-essential.


3. Cash payments or money cards are distributed to the public in advance.


4. The public is advised to buy more than a two week’s supply of food, three

to four weeks if possible. Stores would be advised in advance to have as

much stock on hand as possible. Some provision would be made should the

stores run out before the shutdown begins.


5. Police, firefighters, hospitals and ambulance services remain available but

with reduced staffs where possible. Whatever provisions that can be made for

hospital workers to stay in walking distance of their work (AirB&B, etc.) are

made in advance. The definition of "essential workers" would need to be as

narrow as possible.


6. Whatever mass testing, including tests that are not 100% reliable,

would be employed at the end of the 15 days.


7. Once the shutdown ends, 1/3 of the work force would return to their

jobs (some method, such as sorting by alphabetical order would be

employed). This staged return would allow to test more of those

returning to work immediately. One week later, the rest of the work

force returns.


8. Bars, indoor dinning, gym clubs, etc. would remain closed for 15

more days after the shutdown. Take out only during this period.


9. There would be no limitation on people going outside their homes

other than, perhaps, curfews in major urban areas after 10 PM or

midnight each day. If crime were to accelerate radically, the curfew

could be made much earlier.


10. There would be no limitation on interstate travel, other than those

imposed by the states involving quarantines. The public would be

asked not to travel unless a trip was absolutely necessary and only if

they had a test for the virus showing they were negative.


11. The wearing of masks, including better masks that protect the

wearer, would continue. The mask mandate would be reviewed every

14 days after the shutdown for potential removal.


12, After 31 days from the start of the shutdown, all normal business

activities and travel would resume, consistent with safety measures

imposed by businesses, such as airlines.


13. Prior to and during the shutdown, special attention would be paid

to the issue of indoor air ventilation and whether it would be

necessary, on the return to normal business, to find a means to allow

outside air to circulate in otherwise closed spaces.


14. As employees return to work each employer could, to the extent

possible, establish their own testing system. If rapid tests become

available, even without high reliability, they would be employed. It is

better to know something than nothing. Pool testing could also be

used.

The national social and psychological impact of a complete shutdown

would likely greatly reduce the resistance to masks and other

protective measures. In general, this effort would be explained as the

last “full force” effort to stop deaths from the virus prior to a vaccine.


With a broadbased educational effort, the shutdown could, with good

fortune, help to create a sense of a clear national emergency. If a vaccine

were to become available before the complete shutdown, it seems unlikely

that enough of the population could receive shots to obviate the need for the

shutdown. Specific strategies could be employed, however, such as, first,

making the vaccine available to older citizens and then inoculating regions of

the country so that shutdowns would only be needed in other regions. Overall,

it seems highly unlikely that a vaccine would be available in time to prevent a

shutdown effort in the early fall, 2020.

People need to know what the likely course is for the future. The

educational campaign envisioned also needs to explain why

recommendations have changed based on developments and new

discoveries about the virus. The idea that masks help protect

everyone, including those with compromised health, needs to be

better explained. That fact that masks are not likely to be

recommended, or demanded, as a permanent feature of America life

needs to be emphasized.

Any approach that is not comprehensive, that does not involve a

multilevel effort, will not likely to succeed. What we have had to this

point is piecemeal in the extreme: varied recommendations that

change week by week, resistance from governors and other officials,


propagandized statements on talk radio and right wing television and

no sense of a national emergency due to mixed messages from the

White House. A coordinated, carefully planned effort can work. The

alternative could be 100,000 or more unnecessary deaths coming in

the fall and through the winter.


(more to come, this is a draft, not the final form)

By Doug Terry, written during July and August and first posted here 8,7.20,

8:43 PM, eastern


A method of contact and to post on this draft will be available 8.8.20

World health organization plan

The SPRP outlines the public health measures that need to be taken to support countries to prepare for and respond to COVID-19. It can be used to rapidly adapt National Action Plans for Health Security (NAPHS) and Pandemic Influenza Preparedness Plans (PIPP) to COVID-19, taking what we have learned so far about the virus and translating that knowledge into strategic action that can guide the efforts of all national and international partners to support national governments, scroll below for more.

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