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A tale of two countries

Australia: I do not want to get too far ahead of the data, but it appears you have turned a corner for good. In the past week, you have doubled your testing capacity while loosening the restrictions on who can be tested. Both good things. Guess what? After the first little blip up of numbers, you have settled back to ~300 cases per day. I realize some states and territories are not testing at the same level as NSW and QLD, but unless there is unrecognized clusters growing and avoiding sentinel populations (aged), you still can beat this thing back down.


The strategy to beat this in Australia is to test (a lot), identify and isolate positive cases, and then identify and quarantine anyone who came in contact with that infected case in the past 2 weeks. Also known as contact tracing.


The effort required for contact tracing is the part YOU can personally control. In reality, the trajectory of the outbreak is in your own hands. If you found out today you were infected, how many contacts would you have had in the past 2 weeks?


Your transmission chain contacts would include: Household members. Anyone who touched you or you touched. Any face-to-face contact with anyone within 2 meters for longer than 10 minutes. Anybody who shared a closed environment with you (classroom, hospital waiting room, aircraft). Anyone you handed a credit card, cash, or any item that could harbor the virus.


How big is your contact list?

If you can make this list as small as possible (by staying home), contact tracing becomes relatively easy and you allow the public health officials to get ahead of the virus. By making this list small, you also limit your chance of being infected. Please, limit your contacts and you will be on the other side of this soon.


Bottom line: If the population does its part, and the government does there part, you will find some normalcy emerging in the coming month. You may not be able to travel overseas for quite some time, or if you do, you may find that your trip has a mandatory 2-week isolation stay at the end of it. But, I am cautiously optimistic that my favorite island nation will be OK.

Here are some travel photos for you ;)



USA: The virus is now setting the timeline and all we can do is hope to suffocate it with highly restrictive social measures. Only 50% of the US states have restricted movement of its people, thus slowing the spread of the virus, and it is showing in the data.


New York and surrounding areas are in trouble, due to the high case volume and limits on PPE, NYC hospitals are only testing hospitalized patients. The estimates on current outbreak size in NYC is 200,000 people. There are 23,000 hospital beds in NYC and an additional 4000 surge capacity beds that were built in conference centers and hotels rooms. Currently, 10,054 people are hospitalized for CoVID-19 in NYC. Sometime this week, all current beds will be filled.


When you see the NY Governor begging for help, this is why.


Rikers Island Prison (NY): The virus got into the prison a few weeks back. Due to close quarters living conditions, the virus is spreading 85 times faster in this setting than the average rate of infection throughout the USA. It will be devastating in there for both the prisoners and the people working in that facility. Prison staff do not have access to appropriate personal protective equipment (PPE), there is not adequate cleaning supplies, and there is certainly not the medical facilities available in-house to deal with this number of seriously ill patients. I know the State Governments are working on this issue, but once it gets into a facility, many options available at first will be lost.


Elsewhere: we are mixed bag of mess. There are now 18 states with more than a 1000 cases. Once a state (country) gets to about a 1000 cases, we typically see rapid growth in new cases as well as increasing mortality.


Michigan and New Jersey are seeing ~30% COVID-19% positive rates with their testing. Their case numbers are increasing exponentially.


Louisiana, they are testing well, but it was just announced that COVID-19 had got into at least 11 nursing homes. That will not end well.


Florida is a mismanaged mess. Case numbers and deaths are exponentially rising, more than a 1000 new cases in the last 24 hours, but as a state they are doing very little to mitigate infection numbers and are taking a county-by-county approach to containment. Images came out today of half a beach closed to the public and the other half open. This doesn’t help for containment. FL demographics are also a concern, it squarely fits with the target demographic of this virus. Estimate are 10 of thousands of cases in FL in the coming weeks.


Bottom line: Even when NYC, NJ, and CT get their outbreaks under control, we will continue to see exponential increases in cases in virtually all other states. USA is a big country, with lots of urban centers with high densities of people, expect the numbers of infected to increases substantially as these other cities get hit. In rural areas, the virus will just simmer, and then flare up when it hits a sentinel population (canary in the coal mine so to speak). The longer it takes to get the country on a unified path to mitigation, the longer we go without PPE for our healthcare workers, the longer we will be in this mess.


Some stupidity:

  • Just yesterday, a Washington doctor was fired from his job for vocally speaking out that he did not have the correct PPE to do his job safely.

  • In Tennessee. The Dept of Public Health advised doctors lacking PPE to wear garbage bags and wrap a diaper (nappies) around their face.


Just to step back a little and bring it closer to home: Many people reading this are in Southern MA. We have cases of COVID-19 and they are increasing, but the air is not infected, and at worst the prevalence of infection is 1% in our communities. It is more likely closer to 0.2%; https://infection2020.com/ Look where you live and multiply what you see in your area by 10 (due to lack of testing and asymptomatic cases).

You should remain vigilant in your behavior and social interactions, but feeling like you are going to war when shopping, or that you are running the gauntlet of death while doing necessary errands, is not based on the real risk to us right now. Later today, I will be putting out some short pieces on face masks, animals, and exercise in light of COVID-19. It is time to take back the power this virus has taken from us!


Also, please reach our to family and friends working in healthcare. I can tell you they are stressed, they are anxious, they need support from friends and family.


On the good news side, it has been 40 days since the last confirmed case of Ebola in the DRC, 25 days since the last person in treatment recovered. They battled this outbreak for nearly 2 years and won!

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