(1/x) Now that advice in the West has finally shifted on wearing masks, can people please focus on the *other* anti-virus strategy that has made a big difference in Asia: central quarantine of the infected - particularly the lightly ill?
(2/x) In Wuhan, the city-wide lockdown helped *slow down* increase in #s of infections. (see @XihongLin paper). Exactly what may be happening in NYC now.
But sending sick people home to families in small apartments ensures *rising* household infections.
medrxiv.org/content/10.110…
But sending sick people home to families in small apartments ensures *rising* household infections.
medrxiv.org/content/10.110…
(3/x) In Wuhan, it was centralized quarantine - figuring out how to isolate sick people, even the 80% for whom virus is less serious, so that they don't infect others - that was crucial.
That was what led to a decrease in #s of infected. Not just slowing increase. A *decrease*.
That was what led to a decrease in #s of infected. Not just slowing increase. A *decrease*.
(4/x) Out here in Asia, centralized quarantine is just a standard component of national anti-virus strategies.
Don't want to look at China or Vietnam? Fine. Look at Taiwan's quarantine hotels instead. Note Japan is moving in exactly that direction too.
english.kyodonews.net/news/2020/04/6…
Don't want to look at China or Vietnam? Fine. Look at Taiwan's quarantine hotels instead. Note Japan is moving in exactly that direction too.
english.kyodonews.net/news/2020/04/6…
(5/x) If aim is not just to *slow* down increase in infections, but actually reduce them, have to create safe place for people to self-isolate + not infect families.
Most affected NYC areas are those w/immigrants & poor residents w/families in small apts.
nytimes.com/interactive/20…
Most affected NYC areas are those w/immigrants & poor residents w/families in small apts.
nytimes.com/interactive/20…
(6/x) And there are at least some local governments in the United States who are starting to craft strategies to address this. Here's Wisconsin.
wkow.com/2020/04/01/wis…
wkow.com/2020/04/01/wis…
(7/x) And here's Florida. tampabay.com/news/health/20…
(8/x) Note that both the Florida and Wisconsin models are *voluntary* ones. You're creating options for infected people who are unable to self-quarantine at home (say, because they live with an elderly relative).
(9/x) Naturally, in an ideal world, you'd also like to encourage asymptomatic carriers to self-isolate.
In countries w/effective testing (say, Germany), such self-isolation facilities could be offered as an option to anyone who tests positive.
In countries w/effective testing (say, Germany), such self-isolation facilities could be offered as an option to anyone who tests positive.
(10/x) The point is: you can do a lot with the concept of centralized quarantine in terms of creating options for people to self-isolate and reduce infection risk to family members ... without even *approaching* the truly difficult question of whether it should be mandatory.
