Coronavirus COVID-19 - Global Health Pandemic #83

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Sundog said:
Love your description of the "traffic light system" and whack a mole. That's what we are doing in Ohio.

What is meant by the the "circuit breaker" approach? Shut it all down? How is that different from lockdowns?
Click to expand...
Have to admit, I don't know what the circuit breaker is - will check back and report.

Covid: Circuit breaker preparations under way in Wales

Ok we have a week half term school holiday approaching and it is proposed they have two weeks and we lockdown in Wales for that short period.

Coronavirus: Liverpool mayor considers extra half-term week

Liverpool also considering a 2 week circuit breaker approach. But they want 80% furlough costs from the government.
That's interesting - give us the money if you want us to close. That seems fair.
 
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Sundog said:
So I assume she will be quarantining for 14 days, per CDC guidelines?
Click to expand...

“Both infected people were aboard a flight with Harris last week, though Dillon said Harris was not within six feet with either individual for more than 15 minutes. Both Allen and the crew member tested negative before and after that flight, Dillon said.”

“The CDC recommends quarantining for 14 days after coming in close contact with infected people, which it defines as being within 6 feet of someone who has Covid-19 for 15 minutes or more.”
 
This guidance is from CDC.

(again the uncertainty regarding masks)


Coronavirus Disease 2019 (COVID-19)

Step 3c: Eliciting Contacts
Identify close contacts irrespective of their use of
cloth face coverings or respiratory personal protective equipment (PPE)

CDC advises the use of cloth face coverings to slow the spread of SARS-CoV-2, the virus that causes COVID-19,and help keep people from transmitting it to others. While research indicates cloth face coverings may help those who are infected from spreading the infection, there is less information regarding whether cloth face coverings offer any protection for a contact exposed to a symptomatic or asymptomatic patient. Therefore, the determination of close contact should be made irrespective of whether the person with SARS-CoV-2 infection or the contact was wearing a cloth face covering.

Because the general public has not received training on proper selection and use of respiratory PPE, it cannot be certain whether respiratory PPE worn during contact with an individual with SARS-CoV-2 infection protected them from exposure. Therefore, as a conservative approach, the determination of close contact should generally be made irrespective of whether the contact was wearing respiratory PPE, which is recommended for health care personnel and other trained users, or a cloth face covering recommended for the general public.

Use of recommended respiratory and other PPE by healthcare personnel (HCP) and other workers, who have received competency-based training on proper selection and use, can protect the wearer from exposure to SARS-CoV-2.  Recommended PPE to protect an individual from exposure to SARS-CoV-2 is described in the Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings

If the close contact is a healthcare provider who was exposed in the workplace, risk assessment should be performed as described in the Interim U.S. Guidance for Risk Assessment and Work Restrictions for Healthcare Personnel with Potential Exposure to COVID-19.

  • Contact elicitation is a voluntary and critical part of the case interview.
  • The case investigator can use information from any reports received by the health department, along with the patient’s symptom history gathered earlier in the case interview, to determine the contact elicitation window (the timeframe when the patient was infectious and not under isolation). See Box 2 below for additional guidance on determining the contact elicitation window.
  • A close contact is defined as someone who was within 6 feet of an infected person for at least 15 minutes starting from 2 days before illness onset (or, for asymptomatic patients, 2 days prior to positive specimen collection) until the time the patient is isolated.
  • It will be important that the case investigator clearly explain why close contacts are being elicited and assure the patient that their identity will not be disclosed to any close contacts that they identify.
  • The trust and rapport built earlier in the case interview, combined with open-ended and probing questions, will help facilitate the contact elicitation portion of the interview.
  • Information to be gathered for each close contact can be found in the Contact Elicitation Investigation data elements table in Appendix C and includes the contact’s name and locating information, the setting of the exposure, contact’s work setting and occupation, and any underlying health conditions or other risk factors the contact may have (if known by the patient).
  • In communities near international land borders, specific interview questions should be asked to identify relevant contacts across the border.
  • The case investigator should also confirm the best way to reach the patient for any follow-up discussion.
  • Proxy interviews are essential when the patient cannot be interviewed (e.g., patient is deceased, intubated, unconscious, a minor, cognitively impaired). Key proxy informants are those likely to know the patient’s practices, habits, and behaviors. However, because proxy interviews jeopardize patient confidentiality, jurisdictions should establish clear guidelines for these interviews that recognize the challenge of maintaining confidentiality.
[paste:font size="4"]symptoms will help identify their infectious period. Building on that information, the contact elicitation window is the timeframe when the client was infectious and not under isolation. If there are additional contacts during isolation (such as household contacts), those contacts should also be elicited.

Client with Confirmed or Probable COVID-19 – Symptomatic

When interviewing a symptomatic client, a case investigator should elicit all close contacts from 2 days prior to onset of any symptoms through the beginning of isolation.



Start date: 2 days before symptom* onset

End date: Beginning of isolation period OR until discontinuation of home isolation (to elicit household contacts of clients recovering at home)

*All possible symptoms should be considered, with particular attention to those that may be mild and/or nonspecific (e.g., fatigue, muscle pain) and those less common.

Client with Confirmed or Probable COVID-19 – Asymptomatic

Determining the contact elicitation window for an asymptomatic client is challenging and should be considered an estimate instead of a precise timeframe. Rather than focusing on the suggested start date, a case investigator may want to prioritize eliciting any recent close contacts in higher priority groups (as listed in Box 4).



Start date: 2 days before the date of specimen collection for confirmed laboratory test

End date: Beginning of isolation period OR discontinuation of home isolation (to elicit household contacts of clients recovering at home)

Operational Questions to Consider

  • How can your jurisdiction use technology to facilitate contact elicitation (e.g., asking about contacts that are stored in a client’s phone)?
  • What types of data tools would help increase efficiency?
  • How will case investigators document and transfer the list of contacts to the contract tracer?
  • Will clients be asked to notify household contacts or close contacts themselves? How will client-notified contacts be managed and dispositioned?
  • If an employer knows the identity of an employee diagnosed with COVID-19, how can a list of close contacts from the worksite best be gathered?
Continued at above link.
 
Sundog said:
The Barrington Declaration advocates for focused protection during the pandemic rather than total shutdowns, so it agrees with your quote about protecting the vulnerable. The White House is advocating for the same, protecting the vulnerable, and opening society where you can, lockdowns for hotspots, but not for everyone, while protecting the vulnerable. So there is no "crime against humanity" in any of these positions.
Just clickbait by MSM who have their own agenda.
Click to expand...

Sundog, can't you see how vague this is---- this declaration is really just clickbate...that is my simple point. "Advocating means nothing...

the declaration really says nothing, but confuses greatly.

  • The Barrington Declaration advocates for focused protection. (who is going to fund all those nursing homes???.)
  • The White House is advocating for the same, protecting the vulnerable, and opening society where you can, lockdowns for hotspots, but not for everyone, while protecting the vulnerable. (protecting the vulnerable...HOW???
  • The CDC advocates much more available testing--- it didn't happen for a long time.
  • The Pres advocates that everyone gets the same treatment as he did--and we never will.

The WH is today, saying, zero shutdowns ....so forget hotspots

If there is a huge wave through the fall and we are suggesting, as a country, for everyone to go out and play, and you old folks call to get your groceries......... well ....that will be bordering a humanitarian crisis, if not a crime.

I just believe we have heard so much evidence that we need those vaccines before we will even get close to addressing any herd immunity.

And now everyone is going to be totally confused again.
 
tresir2012 said:
Did you grow up on a farm, out of interest, as I did? My job was shutting in the chickens at night and wonder if that was why I never caught it. MOO.
Click to expand...
No...no farm and no chickens. I was a city girl. I have no idea why I never got chicken pox as I was so well exposed...over and over again over a 25 to 30 year period. It did seem strange and I too have always wondered what made me immune. I certainly managed to get all the other communicable diseases,,,both kinds of measles, mumps and whooping cough. In those days we also had to be cautious for Scarlet Fever, Polio, and tuberculosis, which I never caught. For you younger posters, this is all pre vaccines.....so those of us who lived with childhoods of infectious diseases LOVE vaccines and the scientists who develop them.
 
tresir2012 said:
This guidance is from CDC.

(again the uncertainty regarding masks)


Coronavirus Disease 2019 (COVID-19)

Step 3c: Eliciting Contacts
Identify close contacts irrespective of their use of
cloth face coverings or respiratory personal protective equipment (PPE)

CDC advises the use of cloth face coverings to slow the spread of SARS-CoV-2, the virus that causes COVID-19,and help keep people from transmitting it to others. While research indicates cloth face coverings may help those who are infected from spreading the infection, there is less information regarding whether cloth face coverings offer any protection for a contact exposed to a symptomatic or asymptomatic patient. Therefore, the determination of close contact should be made irrespective of whether the person with SARS-CoV-2 infection or the contact was wearing a cloth face covering.

Because the general public has not received training on proper selection and use of respiratory PPE, it cannot be certain whether respiratory PPE worn during contact with an individual with SARS-CoV-2 infection protected them from exposure. Therefore, as a conservative approach, the determination of close contact should generally be made irrespective of whether the contact was wearing respiratory PPE, which is recommended for health care personnel and other trained users, or a cloth face covering recommended for the general public.

Use of recommended respiratory and other PPE by healthcare personnel (HCP) and other workers, who have received competency-based training on proper selection and use, can protect the wearer from exposure to SARS-CoV-2.  Recommended PPE to protect an individual from exposure to SARS-CoV-2 is described in the Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings

If the close contact is a healthcare provider who was exposed in the workplace, risk assessment should be performed as described in the Interim U.S. Guidance for Risk Assessment and Work Restrictions for Healthcare Personnel with Potential Exposure to COVID-19.

  • Contact elicitation is a voluntary and critical part of the case interview.
  • The case investigator can use information from any reports received by the health department, along with the patient’s symptom history gathered earlier in the case interview, to determine the contact elicitation window (the timeframe when the patient was infectious and not under isolation). See Box 2 below for additional guidance on determining the contact elicitation window.
  • A close contact is defined as someone who was within 6 feet of an infected person for at least 15 minutes starting from 2 days before illness onset (or, for asymptomatic patients, 2 days prior to positive specimen collection) until the time the patient is isolated.
  • It will be important that the case investigator clearly explain why close contacts are being elicited and assure the patient that their identity will not be disclosed to any close contacts that they identify.
  • The trust and rapport built earlier in the case interview, combined with open-ended and probing questions, will help facilitate the contact elicitation portion of the interview.
  • Information to be gathered for each close contact can be found in the Contact Elicitation Investigation data elements table in Appendix C and includes the contact’s name and locating information, the setting of the exposure, contact’s work setting and occupation, and any underlying health conditions or other risk factors the contact may have (if known by the patient).
  • In communities near international land borders, specific interview questions should be asked to identify relevant contacts across the border.
  • The case investigator should also confirm the best way to reach the patient for any follow-up discussion.
  • Proxy interviews are essential when the patient cannot be interviewed (e.g., patient is deceased, intubated, unconscious, a minor, cognitively impaired). Key proxy informants are those likely to know the patient’s practices, habits, and behaviors. However, because proxy interviews jeopardize patient confidentiality, jurisdictions should establish clear guidelines for these interviews that recognize the challenge of maintaining confidentiality.
[paste:font size="4"]symptoms will help identify their infectious period. Building on that information, the contact elicitation window is the timeframe when the client was infectious and not under isolation. If there are additional contacts during isolation (such as household contacts), those contacts should also be elicited.

Client with Confirmed or Probable COVID-19 – Symptomatic

When interviewing a symptomatic client, a case investigator should elicit all close contacts from 2 days prior to onset of any symptoms through the beginning of isolation.



Start date: 2 days before symptom* onset

End date: Beginning of isolation period OR until discontinuation of home isolation (to elicit household contacts of clients recovering at home)

*All possible symptoms should be considered, with particular attention to those that may be mild and/or nonspecific (e.g., fatigue, muscle pain) and those less common.

Client with Confirmed or Probable COVID-19 – Asymptomatic

Determining the contact elicitation window for an asymptomatic client is challenging and should be considered an estimate instead of a precise timeframe. Rather than focusing on the suggested start date, a case investigator may want to prioritize eliciting any recent close contacts in higher priority groups (as listed in Box 4).



Start date: 2 days before the date of specimen collection for confirmed laboratory test

End date: Beginning of isolation period OR discontinuation of home isolation (to elicit household contacts of clients recovering at home)

Operational Questions to Consider

  • How can your jurisdiction use technology to facilitate contact elicitation (e.g., asking about contacts that are stored in a client’s phone)?
  • What types of data tools would help increase efficiency?
  • How will case investigators document and transfer the list of contacts to the contract tracer?
  • Will clients be asked to notify household contacts or close contacts themselves? How will client-notified contacts be managed and dispositioned?
  • If an employer knows the identity of an employee diagnosed with COVID-19, how can a list of close contacts from the worksite best be gathered?
Continued at above link.
Click to expand...

Treser! For the life of me I really really tried to follow all of this above to figure out what you are actually saying!! mask? no mask? once upon a time, no mask? We are building this airplane while we are already down the runway..... we know that!

So could you provide the "gist" of the above... what is the confusion about masks, again????

You have a lot more patience than I do to keep up with the ever changing details of the CDC!!! However, that is what I was hoping the national press conferences were going to do for us.
 
Sundog said:
Even the WHO has come out against lockdowns. So we need to be thinking about how we open up society and still protect the most vulnerable.
Click to expand...

We can open up society if citizens would cooperate with guidelines to protect themselves and others from the virus: for example : masks, social distancing, hand washing and not gathering in clusters of people in places like bars, churches, and even small groups in homes. If everybody would follow these guidelines you wouldn't need to lock down (which we aren't going to do anyway)- what we have now unfortunately are people who won't do any of those things and wonder why we have a surge of cases
-
 
tresir2012 said:
Oh oh.

Another link.

Sen. Kamala Harris cancels travel after communications director tests positive for coronavirus


"Campaign Manager Jen O'Malley Dillon identified the woman as Liz Allen. A non-flight staff crew member on the campaign also tested positive.



O'Malley Dillon said that Harris was not in close contact with either Allen or the other crew member during the two days prior to their positive tests; and as per CDC guidelines, there is no requirement for quarantine. Both people had attended personal events in the last week and per campaign protocol were tested when they returned to work. That's when the diagnoses was revealed.

Harris has taken two tests since Oct. 8, both of which came back negative, most recently on Wednesday, the campaign stated. "
Click to expand...

I am concerned about Biden being so visible these days as far him contracting the virus.
 
nhmemorymaker said:
Sundog, can't you see how vague this is---- this declaration is really just clickbate...that is my simple point. "Advocating means nothing...

the declaration really says nothing, but confuses greatly.

  • The Barrington Declaration advocates for focused protection. (who is going to fund all those nursing homes???.)
  • The White House is advocating for the same, protecting the vulnerable, and opening society where you can, lockdowns for hotspots, but not for everyone, while protecting the vulnerable. (protecting the vulnerable...HOW???
  • The CDC advocates much more available testing--- it didn't happen for a long time.
  • The Pres advocates that everyone gets the same treatment as he did--and we never will.

The WH is today, saying, zero shutdowns ....so forget hotspots

If there is a huge wave through the fall and we are suggesting, as a country, for everyone to go out and play, and you old folks call to get your groceries......... well ....that will be bordering a humanitarian crisis, if not a crime.

I just believe we have heard so much evidence that we need those vaccines before we will even get close to addressing any herd immunity.

And now everyone is going to be totally confused again.
Click to expand...
It's called shielding in the UK and we have been doing it since March, especially when not in lockdown. It's not confusing, just think "don't infect Grandma".
 
nhmemorymaker said:
Sundog, can't you see how vague this is---- this declaration is really just clickbate...that is my simple point. "Advocating means nothing...

the declaration really says nothing, but confuses greatly.

  • The Barrington Declaration advocates for focused protection. (who is going to fund all those nursing homes???.)
  • The White House is advocating for the same, protecting the vulnerable, and opening society where you can, lockdowns for hotspots, but not for everyone, while protecting the vulnerable. (protecting the vulnerable...HOW???
  • The CDC advocates much more available testing--- it didn't happen for a long time.
  • The Pres advocates that everyone gets the same treatment as he did--and we never will.

The WH is today, saying, zero shutdowns ....so forget hotspots

If there is a huge wave through the fall and we are suggesting, as a country, for everyone to go out and play, and you old folks call to get your groceries......... well ....that will be bordering a humanitarian crisis, if not a crime.

I just believe we have heard so much evidence that we need those vaccines before we will even get close to addressing any herd immunity.

And now everyone is going to be totally confused again.
Click to expand...
I think the US might find themselves on the receiving end of UN sanctions if they try this. Allowing covid to spread uncontrolled in the US negatively impacts the entire world, and is a giant slap in the face to a planet that is collectively trying to do something about it.

The idea that you can "protect" vulnerable people while you let a highly contagious pathogen run side-by-side through a "healthy" population is absurd on an epidemiology level. It's also putting at-risk people more at-risk, which is okay, I guess, with some people. jmo
 
tresir2012 said:
It's called shielding in the UK and we have been doing it since March, especially when not in lockdown. It's not confusing, just think "don't infect Grandma".
Click to expand...

And here in Ohio, those of us over 65 have been advised by the Governor to take precautions, weigh the risks of all our activities, and act accordingly. This is the same advice of the CDC and the Americans with Disabilities Act recommends remote working for this population, if possible. That is what allows me to work remotely, although I could go to my office every day if I wanted to, but I weigh the risks, as the Governor advises and as the CDC advises, and so am working remotely.
 
According to Chapter VII of the United Nations Charter, only the UN Security Council has a mandate by the international community to apply sanctions (Article 41) that must be complied with by all UN member states (Article 2,2). They serve as the international community's most powerful peaceful means to prevent threats to international peace and security or to settle them. Sanctions do not include the use of military force. However, if sanctions do not lead to the diplomatic settlement of a conflict, the use of force can be authorized by the Security Council separately under Article 42.

The United Nations Security Council "veto power" refers to the power of the five permanent members of the UN Security Council (China, France, Russia, the United Kingdom and the United States) to veto any "substantive" resolution.

International sanctions - Wikipedia

United Nations Security Council veto power - Wikipedia
 
nhmemorymaker said:
Treser! For the life of me I really really tried to follow all of this above to figure out what you are actually saying!! mask? no mask? once upon a time, no mask? We are building this airplane while we are already down the runway..... we know that!

So could you provide the "gist" of the above... what is the confusion about masks, again????

You have a lot more patience than I do to keep up with the ever changing details of the CDC!!! However, that is what I was hoping the national press conferences were going to do for us.
Click to expand...
In those CDC directions they are basically saying when checking contacts, to ignore whether people wore masks as it is not proven. I will edit to just copy the relevant bit in case I interpreted it incorrectly.

This bit at the beginning.

"Step 3c: Eliciting Contacts
Identify close contacts irrespective of their use of
cloth face coverings or respiratory personal protective equipment (PPE)

CDC advises the use of cloth face coverings to slow the spread of SARS-CoV-2, the virus that causes COVID-19,and help keep people from transmitting it to others. While research indicates cloth face coverings may help those who are infected from spreading the infection, there is less information regarding whether cloth face coverings offer any protection for a contact exposed to a symptomatic or asymptomatic patient. Therefore, the determination of close contact should be made irrespective of whether the person with SARS-CoV-2 infection or the contact was wearing a cloth face covering.

Because the general public has not received training on proper selection and use of respiratory PPE, it cannot be certain whether respiratory PPE worn during contact with an individual with SARS-CoV-2 infection protected them from exposure. Therefore, as a conservative approach, the determination of close contact should generally be made irrespective of whether the contact was wearing respiratory PPE, which is recommended for health care personnel and other trained users, or a cloth face covering recommended for the general public."

In your previous post you said

"The WH is today, saying, zero shutdowns ....so forget hotspots"

Do you have a link for that statement please?
 
Last edited:
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