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March 9th: Travelling

So we finished the marathon Journey to Australia. I had been worried about spending 17 hours on a aircraft with coughing, sneezing infectious people enclosed in a flying metal tube. But thankfully, I only heard a single sneeze (and it was Phillip). In contrast to the low key response I came across in Boston and Dallas, Sydney was like a scene from the beginning of World War Z. Virtually every customs officer, police office, baggage handler was wearing a mask. At least 30% of people walking around the airport were wearing masks. So confused. The response in Australia to the control of coronavirus by the government has been excellent. but it appears everyone thinks the sky is falling. You can tell that Australia is doing well, they are testing lots and only finding a handful of cases per day. It's here, but there is no evidence yet of sustained human-to-human transmission within the community.

In contrast, in the USA things were really quite relaxed (in the airports) for what is becoming progressively worse. Based on genetic analysis of isolates, the Washington State cluster is estimated to have grown to 1100 infected people (lower bound 210 - upper bound 2800), yet we have only diagnosed 117 cases. That leaves a lot of infected people walking around in just one state. This situation is repeating itself across the country. In MA, We have more than 4000 people in self isolation, ~300 people in quarantine, and 28 confirmed cases.

There have been some changes on the travel recommendations

Australia (NSW): made a strong recommendation that elderly and immunocompromised people should limit travel.

USA: Similarly, the CDC made recommendations that you should not go a cruise or a long plane ride, especially if you are elderly or immunocompromised.

Basically, what they are saying is people that are in the danger group for this pathogen, should really take as many precautions as they can NOT to be exposed to this disease.

I want you to also keep in mind something I said earlier, this is not a sprint, but a marathon. There is no evidence that this will burn out or be limited by seasonal changes. This bug will have profound impacts globally for months, if not a year(s). Personally, I would not be making plans to travel anywhere internationally, no matter your age, until we have a much better handle on things. I understand that seems disingenuous as I'm sitting here in Australia, but I would not be repeating this trip now or the near distant future with what I see happening globally.

US-people: I expect that there will be aggressive measure put in place to limit the community transmission of this bug, and this will happen fairly soon. It's only a matter of time before our first city starts to limit movements of people. We have been so slow to start, I expect to see an (over)compensatory response soon. We will see more school closings, restrictions on public gatherings, and changes at work. This will all be in an effort to minimize the number of contacts a person has in a day, and therefore, restrict the chance of the virus finding a host. We have to slow down the community spread so we do not overwhelm the healthcare system.

Do you part: handwashing, social distancing, stop touching your face

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