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As discussion starts to turn to easing of shelter in place restrictions, I am seeing a lot of what I consider to be magical thinking about our ability to protect our most vulnerable loved ones from #COVID19.
Much of this is coming my way because we have posted some early pre-print data on high risk characteristics. A common question I am getting is, so if we know who is most high risk, can't we keep them isolated and let everyone else go back to work?
Let's do a thought experiment to see how this might play out. We know that advanced age is far and away the greatest risk for adverse outcome in this epidemic. So, imagine for a moment we take our elders and do everything possible to isolate them from the community.
We put them in dedicated buildings apart from all younger people. We prohibit any visitors. We bring in all their food and necessities so they don't have to interact with the world. We don't allow them to leave the premises.
Wait... we've actually already tried this. It's A CALAMITY. Why? Because even with the best intentions and the most stringent measures, the world is porus. There is always, always contact with the broader community. It's not avoidable.…
If there is a lot of disease in the community, there will be a lot of disease among high risk people. Period. The best way to protect those we love who may be at higher risk is to reduce the rate of disease in the community at large to as low a level as possible.
Now, how best to do THAT is a whole separate question that many experts are weighing in on. Here's a good summary of four of them with links to the plans.…
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