April 22, 2020

"Ventilation systems can create complex patterns of airflow and keep viruses aloft, so simply spacing tables six feet apart — the minimum distance that the C.D.C. advises you keep from other people..."

"... may not be sufficient to safeguard restaurant patrons.... [A]ll of the people who became sick at the restaurant in China were either at the same table as the infected person or at one of two neighboring tables. The fact that people farther away remained healthy is a hopeful hint that the coronavirus is primarily transmitted through larger respiratory droplets, which fall out of the air more quickly than smaller droplets known as aerosols, which can float for hours....  An air-conditioning unit next to Family C blew air in the southward direction across all three tables; some of the air likely bounced off the wall, back in the direction of Family C.... 'We conclude that in this outbreak, droplet transmission was prompted by air-conditioned ventilation,' the authors wrote. 'The key factor for infection was the direction of the airflow.' Harvey V. Fineberg, who leads the Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats at the National Academies of Sciences, Engineering and Medicine... said restaurants should be mindful of the direction of airflow in arranging tables."

From "How Coronavirus Infected Some, but Not All, in a Restaurant/A limited study by Chinese researchers suggests the role played by air currents in spreading the illness in enclosed spaces" NYT.

From the comments over there: "The implications of this event reveal staggering problems for the commercial airline industry."

And, from a lawyer: "That air currents impact the movement of virus particles is an 'of course they do.' I spent many years litigating environmental and toxic tort cases, and needless to say we saw the spread of all types of toxic substances impacted by air currents, air handling equipment, temperature differentials within a building etc. Not really anything new here, other than they focused on a specific virus particle (SARS-CoV-2)."

ADDED: Maybe there are 2 kinds of people: The ones who will decide never to go to a restaurant again and the ones who will say I'm just going to take my chances. No, I'm thinking in that chance-taking set of people, there will still be an assessment of the chances. How crowded is the place, how far apart are the tables, are the servers masked, does it look like they are sanitizing, is there subtle air circulation, or do they have a conspicuous air conditioner mounted on the wall and bearing down on the diners?

129 comments:

Unknown said...

Surely some ritual will save us

wash hands
wear masks
stay out of AC
stay distant
wear gloves
isolate
Have Dem governors and mayors destroy all business
A vaccine
A malaria pill

anything but antibodies

Browndog said...

I have it on good authority the virus can only travel 5ft 11 1/2 inches through the air unless forcefully projected from the body. Also, it only exists in a droplet, so now I know the human body expels droplets of mucus/saliva up to, but not more than 6ft through normal breathing.

I also have it on good authority being in close proximity of a person outdoors, even for a fleeting moment, can trigger the deaths of many, many people. All the while being indoors, breathing the same air as multiple people for an extended period of time is very safe, and nothing has anything to do with pr0longed exposure and viral loads.

If you've ever wondered if anyone else thought that sometimes it seems our experts treat the virus as if it's airborne the answer is no.

It's just you.

rhhardin said...

What's alarming is that the obvious physics didn't make its way into minds of the naive.

I suppose pilots would as a group know all this intuitively. Once you're in the air, there's no wind. The earth is the thing that's moving sideways, not the airplane.

bagoh20 said...

Now air conditioning? COVID-19 - what can't it ruin?

rhhardin said...

Back before GPS, pilots would do wind triangles. Basically calculating where the bit of air is that will arrive at your destination at the same time that you hit that bit of air, and heading for that bit of air, not the destination. Handheld circular sliderules that did the law of sines were sold.

rhhardin said...

Diffusion unfortunately happens at infinite speed, but fortunately in infinitesimal quantities. Looking closer at where the equations break down, probably it's limited to the speed of sound or speed of molecular motion or something. Everything's in the tails of normal distributions in any case. So diffusion isn't much help. That's what they've been working with.

Ordinary fluid flow is simple, by contrast. If you're downwind, you catch it.

tim maguire said...

Given that as much as two weeks may pass between infection and diagnosis, how is it possible that they isolated exposure to the point of seating arrangements at a restaurant?

rhhardin said...

The worst thing is that after two hours you're hungry again. Chinese restaurant syndrome.

stevew said...

I read these articles as arguments for shutdown of most out of the house activities until the virus is eradicated. That is a fool's errand. Then I think about the emerging fact that this coronavirus is about as bad, in terms of sickness and death, as a middling to bad influenza and wonder if these restrictions will be deployed every year starting in October or November and running through March or April.

The virus cannot be stopped. Individuals need to take responsibility for their own health and change their behavior such that they stay home when ill. We need to return to the protocols used during a typical flu season. Wide scale shutdown is not justified by the results.

Jersey Fled said...

From what I understand, commercial aircraft use HEPA filters that are quite effective at removing particles as small as viruses from the air circulating in the cabin. They are the same filters used in hospital operating rooms.

This came up way back when Americans were being evacuated from Asia and infected individuals were isolated in the rear of the aircraft in an area sealed off with plastic film.

The filters, of course, do not address the issue of close physical contact in a packed aircraft. But subways and busses have the same problem.

Diogenes of Sinope said...

Sensing disaster and suffering from the virus, Lawyers circle above us, looking for the the fattest wounded prey to swoop down on and eat alive.

Ralph L said...

Does this mean the return of high-backed booths?

R C Belaire said...

Those high-flow hand dryers in restrooms are great at mixing the air and if you're the next occupant I have a feeling the previous occupant's "off gassing" is still floating around. Paper towels are the way to go, as are disposable grocery bags.

MayBee said...

We would know if very many people picked this up in airplanes.

But you know, I'm going crazy thinking airflow has something to do with what is going on in New York. Either from the subway tunnels or something in the sewer system.

gilbar said...

and wonder if these restrictions will be deployed every year starting in October or November and running through March or April.

my $0.02's this was the virus that cried wolf
It was GOING TO BE SO HORRIFIC! that we shut down the world
As it turns out what the Actual effects of this virus are, people are NOT going to do this again

One of these days (soon?) we'll have a REAL pandemic, and what are they going to say?
"Millions Will Die!"
"We must lock down, to 'flatten the curve'!"
"Hospitals will be Overwhelmed!"
and people are going to be like: This is where we came in

We took Extreme Measures, to combat an ordinary virus.
It's going to be VERY hard to convince people to do this again: Even IF it's necessary

Trust the Experts! They have been wrong about EVERY THING, EVERY TIME... But This time!

Sammy Finkelman said...

And airplanes have ventilation system, too, you know.

Both the handwashing and the 6 foot rule (both errors complement each other) may fade away.

Sammy Finkelman said...

It seems to me that the virus has a tendency to remain dormant for days. During which the immune system ignores it. Or those viral particles that are.

Ron Winkleheimer said...

The Wuhan Virus is not Captain Tripps. People are not dying in the street. In a couple of weeks things will be back to normal.

J. Farmer said...

Let me reiterate a point I've made many times: We. Don't. Know.

Nobody should be surprised that we are getting things wrong about the nature of the virus or its presentation. We are about six weeks into thus. We are a little less than two months into this. Gathering and analyzing data in the current situation is particularly difficult. Part of the rationale for "flattening the curve" was to buy time to prepare and learn more.

The same people who complain about "experts" getting things wrong have also show a readiness to hype other "experts" for no other reason then wanting to believe their conclusions. People were hyping Knut Wittowski said in an interview at the beginning of April said that "the pandemic is over" because "there no more new cases in China and in South Korea." Wrong. When he is asked about potential deaths (granted the answer is a little hard to follow), he says "that could be as high as 10,000." Wrong.

Stop saying this is like the flu. First, comparing Covid-19 numbers with flu deaths is an apple to oranges comparison. Flu deaths for any given season are estimated by the CDC using surveillance data and statistical models. It also includes all pneumonia deaths, which is why the numbers are reported for "influenza and flu." We still don't know what the numbers are going to be, so it doesn't make sense to compare the current number over a short time frame with the estimated numbers for an entire flu season. Also, even if you recover from Covid-19, you can be hospitalized for weeks and may end up in the ICU. Illness from flu progresses differently than Covid-19, and preliminary information from healthcare providers is that there are differences in presentation in the lungs that may require different treatment plans. It's possible that over reliance on ventilators could actually result in worse outcomes. We still have no idea if Covid-19 increases the risk for long-term health problems or if its effects on the lung result in damage to other major organs.

Bill, Republic of Texas said...

coronavirus is primarily transmitted through larger respiratory droplets, which fall out of the air more quickly than smaller droplets known as aerosols, which can float for hours.... An air-conditioning unit next to Family C blew air in the southward direction across all three tables; some of the air likely bounced off the wall, back in the direction of Family C....

Does that make sense to anyone? The droplets made a bank-shot.

Ron Winkleheimer said...

https://spectator.org/whither-our-nanny-police-state-the-case-of-dr-jonathan-geach/

MayBee said...

I agree with Farmer. We don't know. And just like everything, we are going to find out something we thought we knew just isn't so.
My bet? That asymptomatic people spread the virus at any real rate. If that isn't a thing with other viruses, my money is that it isn't a thing with this one.

Browndog said...

I love nothing more than people that scream "we don't know!" and "It's nothing like the flu" in the same breath.

Fernandinande said...

This means we've been eating other people's spit and snot in restaurants all along.

narciso said...

Liberty dies not with a crash, but with a cough.

stevew said...

The data we have gathered, incomplete as it may be, does not prove that the shutdown was the right thing to do. Was the curve flattened by the shutdown? We don't know; flattened as compared to what? How many lives were saved by the shutdown? No one can say for sure.

"Stop saying this is like the flu."

I didn't but maybe you were referring to someone else.

Roughcoat said...

Farmer knows everything.

gilbar said...

Let me reiterate a point I've made many times: We. Don't. Know. But treat it like a wolf!
Let me reiterate a point I've made many times: We. Don't. Know. But treat it like a wolf!
Let me reiterate a point I've made many times: We. Don't. Know. But treat it like a wolf!

HEY!! Look out! this time, There IS a Wolf! ! !

daskol said...

Right now we are all very attuned to hygiene and as a result other people are disgusting. The reason most people won't give a shit about a restaurant's airflow is because this intense focus on the microscopic is thoroughly unlike us, at least most of us who are not germaphobic. It makes communion among humanity unappealing if not totally impossible. So for most of us, we will go back to macro concerns like people being loud or obnoxious or smelly and stop worrying about the aerosols and droplets they expel very quickly. This will not turn the world into germaphobes because germaphobia is actually rare and strange.

Temujin said...

Which is also why the Governor of Georgia reopened their beaches along the coast a couple of weeks ago, while lefty press and people around the country called him a hick and and more. He wanted to allow people to walk along the coast- while keeping somewhat distanced. And now that has occurred in Jacksonville, FL as well. What is apparent to those of us who can go outside is that, while keeping a bit of distance from others, being outside is the best possible place to be.

Someone should let that political hack who runs Michigan know that the people of Michigan can go outside to garden, ride their powerboat, or even drive up to their northern cottage to sit outside and look at spring. (is it spring up there yet?)

As for restaurants, yes- we will judge the place by how busy, how they manage seating, and if they have an outdoor area that we can use. But at some point, I'm going to need to belly up to a bar. It's going to happen.

narciso said...

ooh shiny, you are getting sleepy

Browndog said...

As for restaurants, yes- we will judge the place by how busy, how they manage seating, and if they have an outdoor area that we can use. But at some point, I'm going to need to belly up to a bar. It's going to happen.

Exactly.

People will protect themselves out of their own self interest, not because of an edict from on high. At some point, people will protect themselves from edicts from on high because they are not in their own self interest.

It's the age old notion that government cares more about you and your family than you do.

narciso said...

abandon all hope

narciso said...

<a href="https://www.powerlineblog.com/archives/2020/04/midweek-in-pictures-volume-6.php> did irony die </a>

tim maguire said...

Fernandistein said...This means we've been eating other people's spit and snot in restaurants all along.

We unknowingly do all sorts of things that would make us throw up if we knew. And it's unavoidable and harmless, so better that we don't know.

As for the virus, even with perfect accounting, it will be a decade before all the deaths attributable to the shut down can be toted up and it will be a year or more before we fully understand the damage to the economy.

On the other side of the scale, we'll never know how many lives were saved by it. History is more likely to forget the dreary details than it is to draw hard conclusions about heroes and villains.

Lurker21 said...

[A]ll of the people who became sick at the restaurant in China were either at the same table as the infected person or at one of two neighboring tables

Yes, but a half hour later they were all healthy again.

jaydub said...

"Part of the rationale for "flattening the curve" was to buy time to prepare and learn more."

Silly me, I was told that it was to prevent our medical facilities from becoming swamped, which it seems to have been done. So, with that goal achieved, now is the time to move the goalposts? I don't think so.

Browndog said...

I was thinking about sneezing the other day. I was thinking in terms of how a sneeze can propel corona virus over 100 ft, and the natural laws of nature and mankind. It seemed to me if everyone was sneezing on each other, how did we not die off as a species long ago?

Then I thought about how our nostrils point downward, towards the ground. Then I thought about how when you sneeze, your head forcefully and involuntarily snaps downward. Thinking that you cannot sneeze upward and outward if you tried.

Just some Browndog thoughts.

Off to the grocery store.

Leland said...

Funny that a limited study by Chinese researchers about the spread of coronavirus is taken as important news, but a limited study of Hydroxychloroquine effectiveness in curing coronavirus is fake news.

I do agree with the lawyer, there isn't really anything new(s) here.

The implications of this event reveal staggering problems for the commercial airline industry.

Written by a person who just learned today what others have known for decades and thus why commercial airliners have HEPA filters.

ga6 said...

20 Apr 2020 https://www.frontpagemag.com/fpm/2020/04/thugs-killed-more-people-chicago-coronavirus-daniel-greenfield/#.Xp8BZoLuYlo.facebook

"While local media broadcast pictures of a deserted Windy City, the shootings paralleled those of previous years. Orders to stay at home, like most laws, don’t apply to criminals.

In one single day in early April, Chicago thugs killed 6 people and shot 21. So far this year, 117 people have been killed, and 522 were wounded. By the time you read this, the numbers will be higher.

Only 86 people in Chicago, so far, have died of the coronavirus."

ga6 said...

Ramadan starts tomorrow, should be interesting. Do closure rules apply to mosques? Dearborn Gov Wittmer...

Sebastian said...

"From the comments over there: "The implications of this event reveal staggering problems for the commercial airline industry.""

Sure, it's possible. In The Panic of 2020, a large number of people began to think about their personal risk differently.

"The ones who will decide never to go to a restaurant again and the ones who will say I'm just going to take my chances."

And then there are the ones that know they are not taking chances because they are immune and the ones that know even if they aren't it's to a big deal for them--no bigger than the flu or getting run over.

"No, I'm thinking in that chance-taking set of people, there will still be an assessment of the chances."

Not that people are very good at calculating their "chances." We've got "real calculations" on that, you know.

Or even others' chances. Ask anyone to judge the chances of an athlete getting sick from WuFlu.

Leland said...

Ramadan starts tomorrow, should be interesting. Do closure rules apply to mosques?

When I read Ann's next post; I thought "Muslims will like this because they want women to wear masks."

Ron Winkleheimer said...

This means we've been eating other people's spit and snot in restaurants all along.

Chances are your toothbrush has fecal matter on it.

https://fhfn.org/how-fecal-matter-got-on-your-toothbrush/

Wince said...

The hoary expression "strappin' on the old feed bag" may have new salience!

BUMBLE BEE said...

Those Air Blade hand driers were called out some time ago as to spreading bad stuff in the air in bathrooms. Particular mention was highway rest sops. Air is flowing in every building whether you notice it or not. My experience was on an HVAC system at one of NYT's printing plants. Search string to use is AIR BALANCING. It is how warmed/cooled air is evenly distributed throughout an area by mechanical means.
My wife belonged to one of those strip mall storefront "gyms". She remained unhealthy for the duration of her contract. Think about it. How many gift shops/fast food places have 50 people huffing to the max on treadmills at one time. Think Herd Immunity!

BUMBLE BEE said...

Shorter version... that lawyer wasn't wrong.

Howard said...

A small low power in line electrostatic precipitator solve this problem

narciso said...

ok fat

richlb said...

I feel better sleeping at night knowing we have lawyers who specialize in air flow.

iowan2 said...

We keep chasing the same squirrel around the same tree with the same results.
How many angles can dance on this contagion? Keep going, keep chasing, if, by miracle, you get an answer, it will not affect a single decision.

What about the controllable?

Do you know Nursing homes, long term care facilities, assisted living, etc, don't have standard hygiene protocols in use all the time? They don't have locker rooms to shower in and out of shift? Do you think something simple like that could have saved the Nation $trillions in shutting down the economy... by a few people taking showers?

But no. Lets dither about not having 100% of the questions answered, instead of taking simple known precautions.

Oso Negro said...

@ J Farmer - There's a lot we don't about a lot of things. Perhaps Gaia has determined an ideal cull rate for human beings on this planet and her orchestra of pathogens is just getting tuned up.

MarkW said...

I'm probably going to be an outdoor-seating-only patron for a good while. I suspect that restaurants with space for outdoor tables are going to have a big advantage until this thing is truly gone.

Howard said...

I'm with you mark w. I think it's going to be that the most people that are likely to carry it are the most careless people and they are the ones that are going to be most cavalier and in close contact so during the reopening it will be very important to avoid groups of stupid people who are oversharing their bodily fluids in confined spaces.

Churchy LaFemme: said...

I'm probably going to be an outdoor-seating-only patron for a good while. I suspect that restaurants with space for outdoor tables are going to have a big advantage until this thing is truly gone.

I'm guessing you don't live in the Deep South. When the air gets thick enough to cut with a knife and the mosquitoes and noseeums come out, people go in.

JMW Turner said...

Man! I may never eat in public again.

Hey Skipper said...

Farmer: Stop saying this is like the flu. First, comparing Covid-19 numbers with flu deaths is an apple to oranges comparison. Flu deaths for any given season are estimated by the CDC using surveillance data and statistical models. It also includes all pneumonia deaths, which is why the numbers are reported for "influenza and flu." We still don't know what the numbers are going to be, so it doesn't make sense to compare the current number over a short time frame with the estimated numbers for an entire flu season.

Good points, but ...

We do know at least some things. Such as ...

In the best-case scenario — prevention measures work, only 20% of Idahoans contract the virus, the outbreak is spread evenly over 18 months, and hospitals can free up most of their ICU beds — there will be one ICU bed for each COVID-19 patient. In the worst-case scenario, there would be one bed for every 14 patients.

“In the Boise, ID region, intensive care units would be especially overwhelmed and require additional capacity,” ProPublica reported based on the Harvard estimates. “Without coronavirus patients, there are only 95 available beds on average in intensive care units, which is 4.4 times less than what is needed to care for all severe cases.”


... from March 23rd is wildly beyond reality. In fact, April all-cause US mortality is at a multi-year low.

And we also know that mitigation measures will only affect infection rate, not extent (in other words, the area below the curve will not change no matter what we do). Which means that so long as infection rate remains below health care system capacity, the eventual outcome — barring the advent of some treatment or vaccine in the relatively new future — will be what it will be.

In Idaho, anyway, the infection rate could be easily be three times (35-ish confirmed cases daily over the last 10 days) what it is and still not strain health care system capacity. Even the peak rate, 205 cases per day on April 2nd, didn't strain the system.

So, it seems rational decision making (as opposed to risk-adverse political decisions) would surmise what mitigation measures would triple the current infection rate. Perhaps things like keeping restaurants and bars at half capacity, body temperature monitoring at points of entry, and frequent hand sanitizing would suffice.

Of course, we won't know until we try, will we?

Howard said...

Unknown: thanks for that tip I think I'll buy stock in deet

iowan2 said...

My mind connects weird things.

Outdoor seating restaurants will have the edge for customers caveat emptor.

Reminds me of my youth. Dad had 3 different "lockers" to choose from, for butchering a steer. He used one almost exclusively. He said mainly because no matter when he stopped, the place was clean, in and out. Always. Also honest. He knew he would get his own meat back with no skimming. The others he did not trust their hygiene or honesty. Then, the the FDA decided us rubes in the country needed protected and mandated upgrades to any locker, butchering for hire. The up grades would have taken all of the lockers profits for 5 years, so he was forced out of business. Two others made the investment, but hygiene is a culture, not mandated stainless steel. If you weren't clean before, you wouldn't clean the stainless steel either.

So the outdoor restaurant may get your nod, but is that the real metric to consider?

elkh1 said...

I will take the table under the air condition vent.

Outdoor restaurant save you from indoor germs, kill your lungs with car exhaust.

Balfegor said...

I think my restaurant preferences are going to shift to (a) outdoor seating, (b) large and spaced apart indoors, or (c) very small and reservations-only.

First two are obvious why. The last because the risk is lower if there's only a few other patrons (fewer contacts), and tracing will be easier if it's all reservations, ideally secured by credit cards so people need to give real names.

Churchy LaFemme: said...

Why don't we all just have tracking chips implanted and be done with it?

Sebastian said...

Meanwhile, out in the real world, just to keep track of the insanity epidemic, from Power Line:

"Deaths in Minnesota attributed to COVID-19 rose to a total of 160 yesterday . . . 17 new deaths included three people in their 90’s, 9 in their 80’s, two in their 70’s, and four in their 60’s. The median age of decedents in Minnesota is 83 . . . Of the 160 deaths to date in Minnesota, 113 are associated with long-term residential care . . . Minnesota counts 237 patients hospitalized with the virus as of today while the hospitals are empty and major health care providers are laying off and furloughing employees . . . Governor Walz . . . justified it in remarks that cited 74,000 possible deaths in Minnesota as a result of the virus. The number might actually be “upward” of 74,000."

Lucien said...

Does this mean that when government stops screwing up businesses, then restaurants and airplanes will be less crowded?

Yippee!!

Ken B said...

“A vaccine ... anything but antibodies”

I'll just leave this here for future generations to guffaw at.

Calypso Facto said...

J Farmer said ... "We are about six weeks into thus.(sic)"

Maybe not ... COVID-19 Was Killing Americans Earlier Than We Previously Thought

"autopsies have now revealed that COVID-19 was responsible for the February 6 and 17 deaths of two people in Santa Clara County. Another person in Santa Clara died of COVID-19 on March 6."

If COVID was prevalent in California in January, producing early February deaths, it may help explain the lack of CURRENT cases in California.

daskol said...

Given the connectedness of west coast cities to Asia, it would make sense for the Chinese virus to have landed first there.

Ken B said...

Farmer said:


Let me reiterate a point I've made many times: We. Don't. Know.

Nobody should be surprised that we are getting things wrong about the nature of the virus or its presentation. We are about six weeks into thus. We are a little less than two months into this. Gathering and analyzing data in the current situation is particularly difficult. Part of the rationale for "flattening the curve" was to buy time to prepare and learn more.

The same people who complain about "experts" getting things wrong have also show a readiness to hype other "experts" for no other reason then wanting to believe their conclusions. People were hyping Knut Wittowski said in an interview at the beginning of April said that "the pandemic is over" because "there no more new cases in China and in South Korea." Wrong. When he is asked about potential deaths (granted the answer is a little hard to follow), he says "that could be as high as 10,000." Wrong.

Stop saying this is like the flu. First, comparing Covid-19 numbers with flu deaths is an apple to oranges comparison. Flu deaths for any given season are estimated by the CDC using surveillance data and statistical models. It also includes all pneumonia deaths, which is why the numbers are reported for "influenza and flu." We still don't know what the numbers are going to be, so it doesn't make sense to compare the current number over a short time frame with the estimated numbers for an entire flu season. Also, even if you recover from Covid-19, you can be hospitalized for weeks and may end up in the ICU. Illness from flu progresses differently than Covid-19, and preliminary information from healthcare providers is that there are differences in presentation in the lungs that may require different treatment plans. It's possible that over reliance on ventilators could actually result in worse outcomes. We still have no idea if Covid-19 increases the risk for long-term health problems or if its effects on the lung result in damage to other major organs.

—————

I just want to say Farmer this might be the best comment I have ever seen from you, and I have seen some good ones. So I thought it worth repeating.

jaydub said...

“And then there are the ones that know they are not taking chances because they are immune and the ones that know even if they aren't it's to a big deal for them--no bigger than the flu or getting run over. “

In my county in NC we now have had 201 confirmed Wuhan cases in our population of 530,000 spread over 638 square miles; so, that would be 0.038% of the population infected, or one person infected in a given 3 square mile area assuming uniform distribution of sick persons throughout the county. As for the 15 deaths that have occurred in the county since extreme social distancing was imposed mid-March, 2 were under 64 years of age, 9 between 64 – 79, and 4 were 80 or older. Overall death rate for the county is then 0.0028%.
For the state of NC, 29% of the lab identified cases and 45% of the deaths have occurred in congregant living facilities (nursing homes, assisted care facilities, and prisons.) There are no specific numbers broken out for the county level in those categories, but if one assumes my county is typical for the state, then approximately 59 of our 201 cases (29%) and 7 of the 15 deaths (45%) are/were in congregant living facilities. If one is NOT in a congregant living facility, then one’s chances of getting the disease or dying from it are reduced accordingly; hence, the general county population’s effective infection rate is (201 - 59)/530,000 = 0.027% instead of 0.038%,and the effective death rate is (15 – 7)/530000 = 0.0015% instead of 0.0028%.) This also means there is one person identified as infected for each 4.5 square mile instead one per 3 square miles.
If one really thinks through these numbers and one realizes about 98% of the counties in NC are not much different than my own, then it’s not difficult to realize the current lockdown policies in NC are not only unnecessary but completely irrelevant to the mitigation of the disease because the infection rate and death rate are already miniscule. If you just look at the infection numbers, fatalities, geography and population density, then the most effective mitigation the state could make would be to close down all the nursing homes and assisted living facilities because that’s where the real problems are, or better yet spend the time, effort and money on isolating the ones living in those facilities from the disease and its effects and who have been shown to be extremely vulnerable. It’s almost criminal that instead the government is wasting resources on the people who don’t need or want protecting and primarily doing so for political reasons.

Balfegor said...

Re: Hey Skipper:

And we also know that mitigation measures will only affect infection rate, not extent (in other words, the area below the curve will not change no matter what we do).

Are you sure about that? That doesn't seem intuitively true to me at all, either based on my simplistic mental model of viral contagion, or on the actual experience in other countries. For example, South Korea as a whole has a total of about 10,000 cases, 2,200 active. Yesterday, they added 11 cases, which is a 0.5% increase over active cases. Meanwhile, New York has 250,000 cases, about 200,000 of which are active. For South Korea to get to New York's level -- in other words, for the area under the curve to be constant across mitigation strategies -- would take about 650 days at a daily increase of 0.5%, or about 22 months. But at that rate of increase, active cases out in the wild are just going to die out before they can replicate.

By the time New York got its daily rate of increase down to 5% (April 12), it already had 180,000 cases. South Korea got its daily rate of increase down to 5% on March 8, when it had only 7,000 cases. And the trendline has been down since then. I don't see any way the area under those curves is going to come out anywhere near equal. The disparity is all the greater given that South Korea has over twice the population of New York State, and Seoul has a larger population than New York City.

I've heard your point made about the area under the curve, before, but to be honest, it seems flatly contradicted by the differing experience of other countries, particularly in East Asia.

JAORE said...

My wife is cold natured. She always wants a table NOT below the a/c vents. Prescient.

Charlie Currie said...

We've been catching, and dying from, the plan old flu in restaurants for decades. So why did we shut the economy down this time?

Francisco D said...

Diogenes of Sinope said... Sensing disaster and suffering from the virus, Lawyers circle above us, looking for the the fattest wounded prey to swoop down on and eat alive.

When the pandemic is over, the lawyers will feast at our expense. In the long run, that may be worse for the economy than the shutdown.

Ron Winkleheimer said...

Why don't we all just have tracking chips implanted and be done with it?

Why bother, most people are carrying smart phones. We are paying for the privilege of being tracked.

J. Farmer said...

@Hey Skipper:

And we also know that mitigation measures will only affect infection rate, not extent (in other words, the area below the curve will not change no matter what we do). Which means that so long as infection rate remains below health care system capacity, the eventual outcome — barring the advent of some treatment or vaccine in the relatively new future — will be what it will be.

I grant the damage to public trust the models did, but that is exactly why I wasn't supportive of using the models to justify our response. There was so little we really knew, and the available numbers were so unreliable, the assumptions we used to build the model would certainly be wrong.

Once community spread had occurred, given that we didn't have testing and preliminary data suggested a long incubation and the ability to spread it without being symptomatic, suppression was not an option. We had to do mitigation. Slowing down the spread would prevent a potential crush of patients in a short period of time. It would also give us time to obtain more data and prepare as cases grew.

J. Farmer said...

Calypso Facto:

Maybe not ... COVID-19 Was Killing Americans Earlier Than We Previously Thought

Yes, I saw this story. By six weeks, I was only referring to when we started taking it seriously. Despite everyone screaming about "panic," our biggest problem was probably that we dragged our feet in responding, and many people were clearly hoping it just wouldn't happen. I started social distancing at the end of February.

Original Mike said...

Just wear a mask while you're eating.

Calypso Facto said...

J Farmer said ... "our biggest problem was probably that we dragged our feet in responding, and many people were clearly hoping it just wouldn't happen. I started social distancing at the end of February."

Perhaps, but additional testing in California that demonstrates the virus was already a long way into running its course there by the end of February while almost completely unknown to us may also show that our biggest problem was a complete overreaction in most areas of the country that are not New York City, with devastating economic effect.

320Busdriver said...

I had to commute between LAX and ORD the other day. I ended up on my second choice of flights due to a delay on the flight that was to leave first. The flight I ended up on is a popular low cost carrier. What was interesting was that the flights load factor I estimated to be on the order of 70%. This is well above any of the loads I have witnessed over the last 6 weeks. The 30 year old skateboarder who sat 2 seats away from me indicated that his fare was REALLY cheap. Looking at the site now I am seeing RT fares on that city pair for $35. That’s one way to fill up an aircraft.

Ralph L said...

Jaydub, have you heard why Wayne Co (Goldsboro) has so many cases per capita?
I'm to your east.

320Busdriver said...

We got some good news last eve. A friend of ours was weaned off the ventilator yesterday after more than 2 weeks. It took several tries. He is only about 50YO.

daskol said...

Hypothesis: if you haven't changed your mind several times over the last 8 weeks about COVID-19, its potential impact, how we should react to it, what we should do more of and what we should stop doing, you're doing it wrong. Completely wrong. This is a novel virus, and if you're too dug into your position and your opinion is a rock, you're not adapting.

Kyzer SoSay said...

Count me in the second group. I'm going out, with my family, and we're not gonna worry about airflow patterns, ventilation, or crowding. If I get the sniffles, we have a cure or two already identified. The only aspect that might keep me away is crowding, but only if there is a wait for a table.

Sebastian said...

jay dub: "If one really thinks through these numbers and one realizes about 98% of the counties in NC are not much different than my own, then it’s not difficult to realize the current lockdown policies in NC are not only unnecessary but completely irrelevant to the mitigation of the disease because the infection rate and death rate are already miniscule."

Well, yes, of course.

"If you just look at the infection numbers, fatalities, geography and population density, then the most effective mitigation the state could make would be to close down all the nursing homes and assisted living facilities because that’s where the real problems are, or better yet spend the time, effort and money on isolating the ones living in those facilities from the disease and its effects and who have been shown to be extremely vulnerable."

Advocated by yours truly from the outset. Isolate the people actually at risk. Develop a support system. Too "ideal," of course. And in one way it is: we're not gonna close down nursing homes, and we can't lock down their staff forever, so the virus is gonna get in. With people in institutions, take reasonable precautions -- but no more. Shutting down golf and MLB won't save grandpa at the Alzheimer's center.

"It’s almost criminal that instead the government is wasting resources on the people who don’t need or want protecting and primarily doing so for political reasons."

Almost? The devastation is the clearly foreseeable effect of policies deliberately advocated by alarmists, wasting resources while imposing on innocent low-risk groups, to no appreciable gain. That is the mark of the insanity epidemic.

iowan2 said...

People aren't dying because they went to a restaurant. They are dying on elder care centers.

Science tells me to close the restaurants.

Sebastian said...

"People aren't dying because they went to a restaurant. They are dying on elder care centers.

Science tells me to close the restaurants."

And K-12.

Yancey Ward said...

Tim Maguire asked the right question:

"Given that as much as two weeks may pass between infection and diagnosis, how is it possible that they isolated exposure to the point of seating arrangements at a restaurant?"

The short answer is they didn't. It is all a guess in this case.

Yancey Ward said...

Stevew wrote:

"I read these articles as arguments for shutdown of most out of the house activities until the virus is eradicated."

Yes, that is mostly true. However, there are subsets of this where it is exactly the opposite arguments made- activities favored by Progressives where it can't possibly be the case that the activity made the spread worse. In particular, that subways and other mass transit helped spread the disease in the New York metropolitan area. There was a paper published a couple of days ago that pretty well proved conclusively that New York's mass transit system was a prime cause of the massive spread there- nothing shocking there for a respiratory disease that is clearly highly transmissible- it is kind of a "water is wet" sort of observation. And yet, every site I have seen that has linked to that paper has been filled with comments from the pro-lockdown crowd that attack the paper and its results with some of the most ridiculous sounding arguments- all seemingly unaware that if you don't have much higher chance of getting infected in a crowded subway car, then what exactly is the purpose of locking everyone down in their homes?

Achilles said...

J. Farmer said...

Stop saying this is like the flu. First, comparing Covid-19 numbers with flu deaths is an apple to oranges comparison. Flu deaths for any given season are estimated by the CDC using surveillance data and statistical models. It also includes all pneumonia deaths, which is why the numbers are reported for "influenza and flu."

COVID-19 death totals are including flu, heart attacks, car crashes, and dying.

There are many heart and cancer patients that are not getting "elective" surgeries like valve replacements right now dying.

They are presumed COVID-19 deaths under current guidelines.

Well they did die because of COVID-19...

mikee said...

My adult daughter took the opportunity of the lockdown to move in with her longtime boyfriend. Ah, the optimism of youth, expecting love to survive long term contact.
She will emerge at least wiser, if not quite yet wed.

Birkel said...

All of the modeling assumes ideal conditions.

How long can the virus survive on cardboard? Don't we care how long it is likely to survive in real world conditions plus some fudge factor?

How long can the virus stay aloft in the air? Don't we care how long it is likely to be infectious in the air under normal circumstances, plus some fudge factor?

Inga said...

“Do you know Nursing homes, long term care facilities, assisted living, etc, don't have standard hygiene protocols in use all the time? They don't have locker rooms to shower in and out of shift? Do you think something simple like that could have saved the Nation $trillions in shutting down the economy... by a few people taking showers?”

Healthcare workers taking a shower before and after a shift isn’t going to do anything to stop the infections in nursing homes. The virus is carried in droplets expelled from the nose or mouth, not from the skin. If a healthcare worker has Covid while asymptomatic and breaths on a patient the showering before the shift did absolutely nothing.

If a healthcare worker is wearing masks during her entire shift the amount of droplets will be decreased, but in no way eradicated. Most dementia or memory impaired patients are not going to keep masks on, so only having the worker be masked isn’t going to be much protection from nursing home patients getting Covid. Testing healthcare workers and patients often if not daily, would help somewhat, but that would be unlikely to happen. There aren’t that many tests available.

The idea that everyone can go about living a normal life with no mitigation techniques, while at the same time protecting the vulnerable population in nursing homes is a fantasy. The more Covid in the general population, the more likely it will be brought into the nursing homes by healthcare workers.

Char Char Binks, Esq. said...

The living envy the dead.

Anthony said...

I won't do anything differently. Period. They got this badly wrong and many people are paying a very steep price for the panic.

Mark said...

It's not like I go to a sit-down restaurant a lot.

n.n said...

12 feet minimum. 24 on the precautionary principle. Cover your mouth, nose, and eyes, too. And if you're sexually active, wash your penis, vagina, and mouth out. If going through the back hole, don't. The virus may share transmission modes with HIV.

Birkel said...

Royal ass Inga:
"The virus is carried in droplets expelled from the nose or mouth, not from the skin."

Smug:
"Let me reiterate a point I've made many times: We. Don't. Know."

Have you two met?

Anthony said...

I posted this over at Insty, partially for the Arizona comparison, but also found a little tidbit while searching as well:

I just looked at flu (and pneumonia deaths) for AZ (I live here, too) and found that in 2017, 875 people died from those causes (https://www.livestories.com.... Consequently, we've shut the state down for something not even close to a normal flu season.

That said, I just did a quick search and came up with this link: https://www.azdhs.gov/direc...

Which says there was an increased number of flu cases by the end of November 2019. I'm wondering if, like California (probably), we had the WuFlu much earlier and spread it around before people knew it existed.

Anthony said...

Damn. Links didn't copy over: https://www.livestories.com/statistics/arizona/influenza-flu-pneumonia-deaths-mortality

and https://www.azdhs.gov/director/public-information-office/index.php#news-release-112219

J. Farmer said...

@Calypso Facto:

Perhaps, but additional testing in California that demonstrates the virus was already a long way into running its course there by the end of February while almost completely unknown to us may also show that our biggest problem was a complete overreaction in most areas of the country that are not New York City, with devastating economic effect.

The fact that we didn't know so much about the virus was precisely the reason we needed to pursue the course we did. The reaction was justified by the threat we face. If a hurricane is heading your way and you go out and get sand bags, bottled war, and some extra gas, that decision doesn't become an overreaction just because the hurricane shifts direction and ends up going through another area.

J. Farmer said...

Have you two met?

Two people making opposing claims here. What in tarnation is goingon?!

Yancey Ward said...

"Which says there was an increased number of flu cases by the end of November 2019. I'm wondering if, like California (probably), we had the WuFlu much earlier and spread it around before people knew it existed."

I wrote over a month ago now that, eventually, someone will start looking into old samples taken last year and probably samples taken from people who died last year (in the US) and find that they had/died of COVID-19. I wrote that this was pretty much a guaranteed result. So far, no one has tried to look at cases that they couldn't at least indirectly tie to contact with cases that first arose in late February- even the cases now found for January in Santa Clara County, CA.

If I were researcher in this field- I would be looking for blood donated anytime last year that is still preserved properly (there has to be quite a bit of this, still, given the shutdowns of elective procedures), and do serological studies on it. Additionally, I would look closely at all cases of death from 2019 that had respiratory failure as a listed cause. I don't know how many autopsies and samples you will find, but you might find old samples taken in hospitals at the time. Not an easy task to gather these samples, but someone will eventually try to do it. I think we will find the first deaths and cases in the US go back to at least last October, and maybe even earlier months.

J. Farmer said...

They are presumed COVID-19 deaths under current guidelines.

Well they did die because of COVID-19...


Those are not the current guidelines. And the CDC data still differentiate how many of the numbers are lab-confirmed and how many are probable diagnoses. People bring up the "flu deaths" repeatedly, despite the fact those numbers are for "influenza and pneumonia" and are estimates based on surveillance data. Only a small portion of influenza cases are lab-confirmed each year.

J. Farmer said...

@Oso Negro:

@ J Farmer - There's a lot we don't about a lot of things. Perhaps Gaia has determined an ideal cull rate for human beings on this planet and her orchestra of pathogens is just getting tuned up.

I am not quite sure what this means. But I obviously agree with your first sentence. We typically have to make decisions about a course of action with imperfect knowledge.

Jim at said...

You have a better chance of dying on your way to the restaurant than once inside it.

Better stay home. Forever.

Birkel said...

We know so little is an opening for the Leftist Collectivists to take over your life.

Congressman Clyburn:
The virus is a "tremendous opportunity to restructure things to fit our vision."

I would default to personal freedom and personal responsibility.

Calypso Facto said...

"that decision doesn't become an overreaction just because the hurricane shifts direction and ends up going through another area."

Double standard for Trump!

But seriously, of course the hurricane reaction can be judged in terms of how realistic it was and what degree of response was taken, just like we can judge the pandemic reaction with better clarity once we begin to acquire more perspective. It's not about calling names (for me, anyway), it's about learning from our mistakes and making more reasonable choices in the future. And for that to happen, we need to be able to honestly call mistakes mistakes and overreactions overreactions when it's the truth, EVEN IF WE DIDN'T KNOW IT AT THE TIME.

J. Farmer said...

@Birkel:

We know so little is an opening for the Leftist Collectivists to take over your life.

What is the step from here to your state taking over your life?

I would default to personal freedom and personal responsibility.

Unfortunately you live in a society that has rejected that. Though fortunately, we live in a society that is fairly limited in its ability to use organized violence against you. It's obviously not zero, but it's very low in historical terms and pretty low in current world terms. The options are to remove yourself from the society or try to change it.

Dust Bunny Queen said...
This comment has been removed by the author.
Dust Bunny Queen said...

J Farmer If a hurricane is heading your way and you go out and get sand bags, bottled war, and some extra gas, that decision doesn't become an overreaction just because the hurricane shifts direction and ends up going through another area.

I agree. HOWEVER, it does become an overreaction if you insist on keeping sandbags all over your house and refuse to go outside ever again. Also if you start berating your neighbors for not continuing to cower inside, even when the hurricane is passed.

Being safe and taking precautions is a good thing. Not recognizing or REFUSING to recognize that the danger is over..is psychotic.

J. Farmer said...

@Calypso Facto:

And for that to happen, we need to be able to honestly call mistakes mistakes and overreactions overreactions when it's the truth, EVEN IF WE DIDN'T KNOW IT AT THE TIME.

I don't have much disagreement with you there. Do you support the federal guidelines for how states can open back up?

J. Farmer said...

@Dust Bunny Queen:

Being safe and taking precautions is a good thing. Not recognizing or REFUSING to recognize that the danger is over..is psychotic.

Except we are not at point where we can say "the danger is over." If that were true, all states would immediately lift all restrictions and go back to business as usual. And no state is doing that right now.

Hey Skipper said...

@Balgefor:

Are you sure about [rate vs. extent]? That doesn't seem intuitively true to me at all, either based on my simplistic mental model of viral contagion, or on the actual experience in other countries.

I'm repeating what I think I know about basic epidemiology: a contagious virus will spread (assuming individually acquired immunity) until the number of remaining vulnerable targets within infection range is below R1.

The only way to stop a virus before reaching that point is to put all remaining vulnerable targets beyond infection range: in other words, stop all activity, period, for at least two weeks.

@Farmer:

I grant the damage to public trust the models did, but that is exactly why I wasn't supportive of using the models to justify our response.

It isn't that the models, going in, damaged public trust. The estimates — particularly mortality ten times that of seasonal flu — were at least plausible.

But a month later, it is clear (or at least it is clear to me) that the existing mitigation measures are now way too stringent.

Despite everyone screaming about "panic," our biggest problem was probably that we dragged our feet in responding.

How do you figure?

Given that the problem is rate, not extent, and the only way foot dragging could have been a problem is to the extent people died who were unable to receive treatment, but would have survived with it.

So far as I know, in the US, that number is zero.

Birkel said...

No state =/= Georgia

Birkel said...

Where we are is not where many people wish us to be in short order. Rep Clyburn, for example, would have us be slaves.

The Soviets were Soviets until they were not. And they were Czarists before they weren't.

We are free until we aren't. Freedom is an attitude.

Smug is a Malthusian? Maybe.

Hey Skipper said...

@Inga:

The idea that everyone can go about living a normal life with no mitigation techniques, while at the same time protecting the vulnerable population in nursing homes is a fantasy. The more Covid in the general population, the more likely it will be brought into the nursing homes by healthcare workers.

Absent putting the vulnerable population in level four containment facilities, or completely shutting society down for at least two weeks, nothing is going to keep Kung Pau Flu out of nursing homes.

Sunflower said...



"Tim Maguire asked the right question:

"Given that as much as two weeks may pass between infection and diagnosis, how is it possible that they isolated exposure to the point of seating arrangements at a restaurant?"

The short answer is they didn't. It is all a guess in this case.
4/22/20, 11:40 AM"

They may not have, but it certainly can be done and is done all the time. When lettuce gets people sick they find the drainage ditch with fecal matter, etc. Discovering where sick people crossed paths isn't rocket science. Maybe they're making this up but this isn't just possible its a job description and its the reason we figure out where food borne illness comes from more often than not.

Hey Skipper said...

How many suicides are Mao Tse Lung related?

From the paywalled article, calls to the LA suicide hotline went up by 8000% in March.

Let's have fun with numbers.

Assume the average suicide age is 25, and the average MTL19 fatality is 70. And that otherwise, both groups would live to 90.

So the average suicide loses 65 life years, and the average MTL19 fatality loses twenty.

Assume that MTL19 fatalities top out at 60,000, and ignore the fact that most would die well within 20 years.

If, nationwide, number of suicides increases by roughly 18,500 (or 40%) in 2020, then this whole lockdown thing will be a wash.

Of course, if the average MTL19 fatality has far fewer than 20 additional years to live — say, two years — then suicides only have to increase by 1,850/year, or about 18 days worth, before the scales balance.

Ken B said...

Sunflower
Yes we do trace the source. Until that is done we pull a lot of lettuce off the shelf. What you can do with time, tests, and knowledge is different from what you can do when all you have is an awareness of the danger.

Sunflower said...

The OP seemed incredulous that it could be done. My only point.

Nichevo said...

Airlines at least will have to vent from below and have returns all along the ceiling. What an opportunity for HVAC worldwide though if EVERYTHING has to be gutted and redone!

Yancey Ward said...

Sunflour,

You can find a link, but you can't rule out the possibility that there is more than one. That is the problem Maguire was pointing out. Just to give you an example- I go to a gym every day, and I probably shop at the same grocery stores and shopping centers as the people who go to my gym- we are a small town. Additionally, I and all the other members have multiple other links vis shops, restaurants etc. With an infection spread wide enough in a community, you can even use a time stamp to narrow down the right link in transmission. All you are doing is guessing in this case.

Yancey Ward said...

I am incredulous they did it successfully in this case given the widespread nature of the infection in that location.

Sunflower said...

Nichevo said...

Airlines at least will have to vent from below and have returns all along the ceiling. What an opportunity for HVAC worldwide though if EVERYTHING has to be gutted and redone!

4/22/20, 2:45 PM

You're right about that. Most of the HVAC equipment is buried in huge companies like UTX but if that were to become a code retrofit somebody would start rolling up all the regional HVAC service companies.

Sunflower said...

@ Yancy. Fair enough.

Cloudesley Shovell said...

Whoever made that comment to the NY Times article is an idiot with no understanding how aircraft environmental control systems actually work.

Aircraft ECS systems are completely different than systems for buildings. Read how they actually work in this Boeing publication, via the Internet Wayback Machine.

Bottom line up front, aircraft cabin air is completely replaced every 2.5 minutes or so, or about 25 times per hour. The aircraft ECS system "provides essentially dry, sterile, and dust free conditioned air to the airplane cabin at the proper temperature, flow rate, and pressure to satisfy pressurization and temperature control requirements."

More at this link. https://web.archive.org/web/20110524110211/http://www.boeing.com/commercial/cabinair/ecs.pdf

Ken B said...

Cloudesley
If the air is replaced it that often it needs to flow continually and ubiquitously. That’s what your link says too. Won’t that mean spreading?

Sunflower said...

Aircraft have HEPA filters in their ducts, so the air circulates but a proper system should catch nearly all the bad stuff.

Home and commercial forced air can be filtered as well, but it would seem that returns in the floor, which are common, are plausible as a way to push the virus through the whole system. Depends on what the research shows.

Norm said...

How does this effect patients who for many other reasons than C-19 have to receive blood transfusions?