What is there to stop the spread of the virus after the lockdown is lifted?

[Doodley]

The spread of the virus will peak, then the number of cases will fall, and this is all being achieved by shutting down businesses and social distancing, plus testing is playing a limited role in containment.

My question is what is to stop the spread from taking off again once the official cases are back into the hundreds and we lift restrictions? Churches can recongregate, but it only takes one infected person to spread it to dozens, who will then spread it to others. Same for schools, sports stadiums, theaters, restaurants, places of work.

What strategy, if any, will be in place to prevent us simply going back to where we were a few months ago and seeing infections rapidly spread through communities and across the country once again?

[customerserviceguy]

1. My strategy

will be to restock, cautiously. I might be the last person wearing a mask someday, but I don't care if people think I'm a fool for doing so.

If a second wave isn't here by a year from now, maybe I'll drop my guard at that point.

[Girard442]

6. In my experience, looking like a fool has never killed anyone.

Being afraid to look like a fool definitely has.

[Tribetime]

21. Yes I'm concerned a mask will mess up my golden locks

An orange spray tan so I refuse to wear one

[tanyev]

9. Yep. I already had a good stock of canned and frozen foods

because I assumed at some point in the Trump presidency we would be bartering food and ammunition. Did not foresee the hand sanitizer and toilet paper crisis, though. I’ll have to work on that.

[marlakay]

12. I have the same strategy

We are retired so going to take it easy this next year until vaccine comes out.

[lagomorph777]

52. Tests (for infection AND antibodies) will have to be universal, cheap, and frequent.

That is more likely to happen long before a vaccine. It can guide a lot of useful changes.

[BComplex]

63. I've totally given up hope on universal tests being available.

I just don't see it's ever going to happen with trump and the republicans in power.

[lagomorph777]

66. But Trump's on his way out.

We'll start the cleanup after he's gone. But we'll prepare well in advance.

[BComplex]

67. I hope you're correct about that!

More than ever, we need to stop any further republican agendas for the next 30 or 40 years.

[Beartracks]

80. 'stop any further republican agendas for the next 30 or 40 years"

This most definitely must be done if this country is to get back on track being America.

The upcoming election isn't just about Trump and it's certainly not just about 2020. It's something that must be sustained and built on year after year after year -- local, state, and federal -- actively keeping Republicans out of elected office for at least two generations. When they amass any power or accumulate in office in large enough numbers, Republicans start to think way too highly of themselves and then they have a track record of Fucking. Things. Up. because they don't know how to govern, despise government, and end up focusing on themselves instead of serving the public good.

==========

[BigmanPigman]

23. I was the only one wearing a mask and gloves for 3 weeks and

I don't care if I continue to get nasty looks when they start letting people out again. Fuck them! I will have the last laugh.

[tblue37]

30. Same here. I am glad I retired a year ago! nt

[Eyeball_Kid]

41. IMO, the waves will keep coming until:

1. A vaccine is discovered.
2. A natural immunity to the virus develops within people. Some folks believe that anti-bodies, manufactured after an illness, will keep multiple infections from occurring. There is no evidence that this will occur.
3. Trump is no longer in power. Why? He is not throwing the full weight of the government into saving lives. He's pretending to know what to do. He's not treating American citizens as equally in need of safety, security, and good health. He's playing favorites.
4. Tests for CV-19 are for everyone on demand, and an antibody test is available for everyone on demand.
5. The private market is no longer part of the CV-19 decision-making system of resistance to the virus.

[Igel]

49. The first two are adequate and necessary.

#3-5 are simply variants, more or less under control, as to how #1 or 2 happens.

#1 is underway and the medical folk are saying it can't be rushed. Government and non-government, pharma and non-pharma. Pick the one you trust, but they all say the same thing. (Caveat: They will say that, but if it turns out to be a great success and they can tell this early, they'll license it for use before the clinical trials are over.)

The question is when #2 might happen. For that, we need to know how much of the population was infected and the status of the asymptomatic folk's immune systems. For all we know, we're at 25% already. They need to test NYC residents in a large random sample to see where the barely moderated curve ends as far as immunity is concerned, but it might be drop off because of herd immunity. And, no, the PCR tests can't give us this information. For that we do need the antibody tests, but first on a large random sample, not initially as individual-over-society fear-based tests.

People still show they don't understand what flattening the curve was intended to accomplish.

[customerserviceguy]

60. Good points

And I like your username and avatar!

The election is only seven months away, we can all survive for that.

[SheltieLover]

76. This!👆

#3 & 5 being attained will allow for the others to occur.👍

[cilla4progress]

79. I'm

with you!!!

[The Velveteen Ocelot]

2. Herd immunity if enough people get it, vaccination when one becomes available.

In the meantime we can only hope that an effective treatment is developed and the hospitals can manage when people do get sick. But it's likely to come back, just like the flu did in 1918-19. I'm planning on staying at home until it's actually safe to go out.

[Texaswitchy]

4. 1920 also.

My baby aunt died from it.

Just six months old.

[Cha]

65. Aww.. sorry. My paternal grandfather

passed on in 1919 from the Spanish flu.. my dad was just 2 years old.

My granddad worked at the Railway station in a small Colorado town.

[Doodley]

10. How does herd immunity protect those who are most vulnerable to the most serious complications?

[Ace Rothstein]

17. Eventually there won't be enough hosts to keep passing the virus around.

Assuming you are immune once you've had it.

[Eyeball_Kid]

42. That's a big assumption. There is no evidence that immunity is applicable

across the mutations of CV-19.

[Igel]

50. The mutations tend to be all over.

Some affect proteins that a vaccine might target. It's an important question as to what the T-cells target. I haven't seen a hint that anybody's proposed a target protein.

That might account for the cases of reinfection. Or crappy Chinese tests might be enough, since every instance I've seen has been China-sourced. Or maybe it goes dormant, or something else. Western researchers can't replicate the work, and while Chinese researchers are competent and often talented, they're also constrained by politics. "Reinfected" is safer than "we screwed up."

[davekriss]

20. Herd immunity: it becomes more difficult ...

... for the virus to ‘find’ hosts, thus less likely to rage through a population.

Right now, the virus can easily jump from host A to Z. But if C, D, M through R, already have antibodies to fight the infection (from previous infections), it becomes less probable for the virus to make it to Z.

[The Velveteen Ocelot]

27. Same way as for any other disease.

If enough people are immune, the disease isn't as widespread and it's less likely that people who aren't immune will catch it. That's why people ought to get flu shots - not only so they don't get it but so people who can't be vaccinated for some medical reason will have less exposure to it.

[Eyeball_Kid]

43. It doesn't. If you're vulnerable to CV-19 and you get really sick,

herd immunity means that you just die.

Herd immunity as a concept assumes that it's something like an "environmental" attack on our species. We presumably can develop an immunity as a species, but that only occurs after those most vulnerable are killed off and can't pass on their vulnerability to their offspring. This is how trees, as species, fend off blight. The blight can kill off massive amounts of trees, but those left standing are more resistant to the blight, and therefore develop strengths (in their offspring) against the blight that is doing the damage.

So herd immunity works if you, as an individual, can accept that YOU, your children, or your parents will DIE from the virus, and there's nothing anyone can do about it. Herd immunity means that if you get infected and you survive, then that's good. If you get really sick, you start to plan on the color of urn in which you want your ashes to be placed.

As an aside, Boris Johnson was all in on the Herd Immunity idea until those acquainted with him started to get infected. THEN JOHNSON GOT INFECTED. Now he's a proponent of the NHS and doesn't bring up Herd Immunity anymore.

[Igel]

51. No, it's not primarily a biological thing.

I don't have an immunity to polio because there are genetically polio-immune people. I have it because of a vaccine.

Herd immunity with things like a cold tends not to be too lethal, but it requires that the herd become infected to the point transmission is difficult. I may meet just one person today that's not immune, and if he gets sick big deal--in the two days he's infectious he'll meet nobody to pass it onto. Transmission dead ends. Or he may meet one person in the two days, and it continues, low grade, small scale.

We're not trees.

But with a lethal virus, it'll require deaths. Flattening the curve just keeps the case load low enough that the hospitals keep working and there are treatment to reduce that instead of leaving people who'd survive with care die unattended. For some groups, the death rate is like the flu or less. (For others, fairly high--but we're talking maybe 1 in 50. That's a good number of people, but the herd doesn't have to be age balanced in its immunity.)

Vaccines provide herd immunity by short-circuiting the process. Given a live but attenuated or a dead virus (sometimes the dead virus does nothing) you develop the immunity of somebody who did get sick, without the pesky side effects of serious illness or death. It may take several doses, like polio (used to? does it still?).

Boris Johnson's policy wasn't the black/white simplistic thing that his political foes like to parody it with. Think about how (R) described Obama. Same kind of thing--not quite right at best, horribly wrong at other times. Politics and truth aren't always great bedfellows. So the original BoJo plan had a list of options, all of which were recommended but some recommended more than others. It's like the CDC guidelines and masks--masks (and scarves) were in the guidance from early March, but never quoted because while it was an option, it wasn't to be stressed. (And people can only keep one thing in working memory at a time, it seems, so if you say 'social distancing *and* masks' they get confused, hear 'social distancing *or* masks', and you only get masks--still #2 in the list, by the way.)

Social distancing and work from home were on that original British list. Fairly high. But not at the top. He flipped when the slope of case load increase was too steep and the peak was going to be high, because the curve needed to flatten. After that he tested positive. For that, you have to look at the original sources, not what people who have a particular stance say you should think about what their opponent says.

[The Velveteen Ocelot]

53. It won't prevent you from getting sick if the virus is around for you to catch.

But if there are enough people around you that are immune, you are less likely to get it in the first place because there will be fewer people to catch it from. It's not the solution, obviously, but a combination of herd immunity and vaccination is what prevents measles epidemics, for example.

[uponit7771]

68. THIS !!!

[DBoon]

44. It makes it harder for the virus to infect them

The virus can't hop from person A to person B to vulnerable person C if person B is immune.

it won't make it easier if you get sick, but it reduces the chance of that happening.

[Eyeball_Kid]

45. There is no way to know if someone who is "immune"

from the virus can't carry it and pass it to someone else. (Since the virus can remain viable on foreign surfaces for hours, days, and even years, it can also remain viable on an immune person's fingers and clothing.) Because we don't have testing for everyone, at least one other factor comes into play: people can carry the virus, NOT BE IMMUNE and NOT show symptoms, and pass it on to someone else. It's also possible that the people who get the virus may be vulnerable to getting infected a second or third time. WE DON'T KNOW ENOUGH about the virus to make these kinds of conjectures.

So until we can test everybody multiple times, the herd immunity idea is just fantasy. Further, the herd immunity concept means that we must accept it that a certain number of people will die, as a given probability. Herd immunity is conceptually similar to Darwin's natural selection.

[DBoon]

46. No - there are multiple falsehoods in your statement

Viruses cannot remain viable for "years" on surfaces. No virus does this. It must infect a host to remain vaiable for any amoutn of time. According to the NIH, Coronavirus is at most viable for hours outside a host https://www.nih.gov/news-events/news-releases/new-coronavirus-stable-hours-surfaces

The coronavirus may infect people while showing minimal or no symptoms, but the infection is not indefinite. After a period of time the virus ceases to replicate.

All evidence points to a long lasting immunity for Coronavirus as with other viruses (for example smallpox). Experiments with other primates indicate this is the case https://www.livescience.com/monkeys-cannot-get-reinfected-with-coronavirus-study.html

Herd immunity is not a fantasy - it is how vaccines become effective even when 100% of the population is not immune. That is how, for example the measles vaccine works. See https://thehill.com/opinion/healthcare/441770-cdc-herd-immunity-helps-to-protect-the-entire-community - not a scientific citation, but accurate.

You statement is a whole series of unsupported or provably false statements. Viruses don't act that way.

[Igel]

54. They've shown "hours."

They've shown that the virus after 3 hours on steel is viable.

They have not shown that it's present in sufficient quantities to infect a person. And that was starting with a pretty significant amount.

Everything after that could be viable virus, trace amounts or in large quantities, or dead virus. The tests weren't done to determine that.

It's pretty clear that we can quote Paracelsus here, the dose makes the poison. And it's coming a bit into focus what kind of dose of the virus is necessary to infect. So even if there is viable virions after 17 days (which is far from shown), the viral half-life might be such that you'd need a pile of it for it to stand more than a trivial chance of infecting a person. They'd usually get to this information by infecting people, but this bug's a bit too dangerous for that so they have to approach it a bit more circumspectly and circumstantially.

So we don't know enough to say a lot of things--reinfection? How dangerous is it, really, after an hour or a day? Can a person actually carry it on their person and transfer it doing typical activities to another? Until then, we run the risk of being naive optimists, all is perfect, or gloomy prophets of doom, we're all going to die. No need to be either. So let's not.

When we get to that bridge, we'll likely know enough information to be able to cross it. We're not going to be able to cross it before we get to it, in any event, so why stress out over it?

[dawg day]

61. I'm wondering how many people have been exposed

And don't get it. I mean close exposure, like their spouse or child. What protects them?

[obamanut2012]

64. Some people have natural immunity to some things

Or, they get it very, very lightly. The Bubonic Plague and the Sweating Sickness ravaged Europe, but some people just didn't get it, or barely got it, while people in their same households got it and died hours later. Same with HIV/AIDs.

[tblue37]

33. I think we'll get antibody treatment before we get a vaccine. There are ongoing antibody

trials now.

[The Velveteen Ocelot]

34. Good. Whatever works.

[Texaswitchy]

3. Nothing I guess

This needed to be caught early in China.

The horse is out of the barn now.

[Girard442]

5. Well, it would be nice if we had widespread healthy-people testing.

Also testing for immunity. Without those two things in place, it's hard to see how spreading won't resume.

[Eyeball_Kid]

48. This is the major failing of the Trump Adminstration.

They could have nationalized the effort to provide testing to everyone and have the capacity to test multiple times. Trump could have done it, but didn't for thousands of bad reasons. He STILL won't do it. It's the best way to start saving lives, and is well within the US' capacity to do so. But Trump won't do it. And the GOP won't tell him to do it. No one wants to jump in with both feet and save the most lives possible. Lives are dispensable. Lives don't matter. Only Trump matters.

[jberryhill]

7. Nothing

But the point is indeed to take it as a series of small waves instead of one great big one.

[Doodley]

11. Until everyone is infected?

[jberryhill]

13. Look at Figure 4 in this paper

Here, this paper explains the approach:

https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf

[Ms. Toad]

40. Thanks for posting this -

I was too lazy to go find it.

[davekriss]

22. Yup - more survive if hospitals aren't overrun

[emmaverybo]

8. Until there is a vaccine available, as I understand it, whatever cases were missed and those

imported will “seed” a new epidemic.

Strategies Singapore and China used probably will not work in our society and certainly not with distrust of government and law enforcement. We can hope mass testing is used, but without isolating cases and the ability to trace contacts, testing alone has some value, but does not stop
the next wave.

We can hope medicine finds an effective treatment.

Very worrying, the fate of many countries in Africa. Without global medical and economic help, this disease will utterly devastate that continent. Will other countries be in any mood to forgive indebted nations?

[jberryhill]

16. It will not "utterly devastate" them

Millions of deaths are not tolerable. A disease that is up to a couple of single digit percent fatal is really, really bad, but is not some kind of extinction level event.

[emmaverybo]

24. It will devastate them economically. Yes. And they will have more deaths in parts of Africa that

lack health infrastructure. I am simply pointing out that as hard as we think we have it here, the toll on so many levels this virus will be take on a continent already dealing with mass cases of tuberculosis, malaria, and Aids, will rival our distress, bad as it will be.

[Azathoth]

14. There is nothing to prevent it coming back

We are looking at some level of social distancing continuing into next year.

It's going to be a new world once the economy starts up again.

[Ms. Toad]

15. Multiple waves are expected.

If more universal testing is available, we can quarantine individuals testing positive, contact trace, and isolate (as we should have done from the beginning). We can aso identify hot spots and shut them down in smaller geographic areas than are currently shut down.

But the best models do predict waves if we successfully flatten the curve now.

[Doodley]

25. That makes sense. Unfortunately, we don't have a president who can deliver that.

[Ms. Toad]

39. States and private industry may step up.

Ohio will start testing people who are not known to be sick soon to get a sense of how widespread undetected cases are. As tests become more available others will start. I know there is a consortium of governors of Ohio and the states surrounding Ohio working to figure out regionally how to control this thing.

[Igel]

56. We don't have a government designed for that.

People keep missing the point that it's a *federal* system. It's not Europe, when the local governments derive authority from the central government because the central government basically just took over from royalty.

We have no national elections, for example--we elect state representatives and send them off. While the central government is far more powerful than the founders imagined would be possible, it's still the case that we have 50 states and they have their own areas of authority. We hate that idea when we want the feds to impose something--but love it, say, when it comes to legalizing weed.

Fauci's been clear on this. First local approaches; then state; then federal.

[JCMach1]

18. Nothing... See 1918 for reference

[BigmanPigman]

19. We will have waves until there is a vaccine.

If anyone refuses the vaccine they should be publicly shamed. They should not be allowed to go to work, go to school or go into the public at all. The damn vaxxers will kill everyone.

[Doodley]

26. Would you trust a vaccine hastily produced by this administration?

[jberryhill]

29. Donald Trump is not making a vaccine

And it may surprise you to know there are countries in this world other than the US.

[Doodley]

35. Of course he isn't personally making it, but he could personally choose the company that does

develop it and tell them to "make sure" it passes any medical trials. We have a corrupt president who is pushing pseudo-science and unproven drugs everyday. I for one, would not trust any Covid19 vaccine while Trump is president.

[BigmanPigman]

31. Not THIS admin!

I will trust it if my Blue State governor (CA) says it is OK though. I trust Newsom, and Cuomo too.

[The Velveteen Ocelot]

32. Fortunately, scientists around the world are working on a vaccine.

An effective one might be developed elsewhere. The problem, of course, will be how to have it made available here without Trump turning it over to some private enterprise to make money off it.

[tblue37]

36. Bill Gates is funding the building of 7 labs & production facilities to research vaccines and

produce them. Instead of trying them out one after another, they will try them simultaneously, and then choose the best and manufacture it. The idea is to speed up the process.

Gates said that, yeah, there will be a financial loss of a couple of billion dollars by dropping the less successful vaccine attempts, but he considers that better than wasting time by trying them one at a time.

The Trump administration is not involved in the project.

[Doodley]

37. Wow! I didn't know Bill Gates was doing that. Impressive or what?

[tblue37]

38. Here's a link to an article about it. He expects to lose billions:

https://bgr.com/2020/04/04/coronavirus-vaccine-bill-gates-ready-to-risk-billions-on-7-candidates/

[crickets]

74. Thank you for that link. nt

[BigmanPigman]

59. Now that is putting your $$$ where your mouth is!

Thank you Bill!!!!!

[roamer65]

55. Probably for about 3 years, yes.

The flu pandemic ran from January 1918 until about December 1920.

[uponit7771]

69. +1, The first wave might be the biggest but it wont be the only one even in S Korea they have to be

... damn near perfect to keep from spiking

[Flaleftist]

28. Without a vaccine or fast and accurate testing, this could be a problem for a while.

If everyone wore good masks and practiced distancing, that could help.

[uponit7771]

72. Trump said they can make this 15 min test machines at 50000 a day. Either they're lying again

... (which is most likely) or they're keeping them from being distributed.

We're screwed with this guy in office.

[Calculating]

47. Nothing at all

Make no mistake about it, this virus isn't going anywhere. I suspect it will be with us for quite some time just like the seasonal colds and influenzas. The goal is to just slow the carnage a bit while we develop a vaccine for vulnerable individuals. The common flu would also be a huge problem if there was no vaccine.

[grantcart]

57. Only massive testing will help to control another break out

If you get the number down to single digits then you have to have massive testing to identify any residual chains and then you can do trace follow up which the CDC and the local public health organizations are quite good at

People who have been identified as exposed will have to get quick testing and if positive be quarantened

China is doing this with phone apps that show outbreaks and using phone data to find out who was exposed. People who are negative are given a green colored ID on their phone, If you might have been exposed then you are red until retested. You have to show your phone at checkpoints and entering buildings.

Positives are sent back to home and their door is sealed and inspected. Food is provided. After two weeks they are green and can go back out again.

[uponit7771]

70. Please ... Please ... Please ... Make this an OP for the sake of all of us. Send it far & wide that

... that we need a minimum amount of massive testing on top of testing the symptomatic.

[bullwinkle428]

73. One would think that a country that put the first man on the moon, over 50 years ago,

is at least capable of managing this kind of ongoing test program in order to allow a genuine restart of the economy and "normal" life in general, but at this point, all bets appear to be off.

[uponit7771]

75. THANK YOU !!!

[kentuck]

58. Trust and hope and....

..prayer.

Lots of prayer.

[Raine]

62. Only what a person can do for themself

like keep washing your hands, not touching your face, staying 6 ft away etc etc.

[MineralMan]

71. Nothing. Just keep doing the social distancing stuff.

Expand it.

[matt819]

77. IMHO

Absolutely nothing.

I think we just need to be sensible. Keep wearing gloves for a while, and masks if you feel like it. Continue to exercise physical distancing. Continue washing your hands. Don't go out as often as you might otherwise. Avoid crowds. Continue, gradually, to stock up of stuff. Masks, gloves, canned goods. No need to spend hundreds of dollars every week - not that any of us could - but slowly. We plan to replace our broken freezer and slowly add to that. Just bought another dozen mason jars for canning when that season comes. Spouse is expanding the garden for our use and to donate to the local community kitchen, now and next season, and next. . .

If you go to church, sit in a less crowded place. Avoid sporting events. Keep an eye on the people around you. Kids in school? That could be a challenge.

I'm sure at some point we'll all move on, but things have to change, and although we can't control other people's behavior, but we can control our own.

[cilla4progress]

78. It will require universal testing

and hopefully some treatments and a vaccine.

That's it!