Is there a practical strategy for return to the normal life as we knew it, or did we yield to the coronavirus invasion?
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Waiting for mass vaccination would be a passive acceptance of 100,000s more deaths, millions hospitalized, long covid quality of life, and severe economic consequences.
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Imposing restrictions to combat transmission (shut downs, stay at home orders) appears in some places politically suicidal, still the question whether to close or keep open becomes mute. Once hospitals overflow, and deaths are out of control, there is no choice but to close.
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Waiting for covid to tell us when to close has led to the recurrent destruction of our normal life, and it is already almost a year that we are in an ailing economy with frustrated social and cultural life, and coping with mass deaths and hospitalizations.
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So the question is not whether to close, but when and how to close.
Long term partial closure has a much worse effect than short term strong closure.
Getting the cases down rapidly is much better.
Acting sooner is much better.
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Observe the wave of COVID cases, when allowed they grow exponentially reaching unbearable values within about 4-6 weeks. When this triggers a strong shut down, it takes 4-6 weeks exponentially to reduce the cases.
Sooner or later and not that much later, you have to close.
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The more substantial question is how and when to open—the EXIT strategy.
The only exit strategy is elimination, or sufficiently close to it so that contact tracing and “fire fighting” stop a few cases or small outbreaks. Everything we know says this is the way out.
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The goal has to be understood.
Getting there is like landing a plane, you have to do it intentionally.
What is helpful is that the closer one is to zero the more control you have. The best strategy is the “Green Zone” exit strategy, opening areas that are free of the virus.
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For a short period of time restrict travel between zones, open them safely, and relax travel restrictions as multiple areas become COVID free.
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For some reason, despite the success of this strategy in other countries* many are concerned about doing it successfully and are ready to give up if they are not guaranteed success. But most of the benefits are already gained even if the ultimate goal is not reached.
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*Including Australia, Taiwan, New Zealand, Singapore, Vietnam, Thailand, China, and Atlantic Canada.
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Many are concerned about whether others will cooperate, and the experience is that the vast majority do, and the strategy is robust so that if some don’t participate they can’t stop success. Enforcement is justified, diminishing their importance (ignoring them) is helpful.
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Let’s stop focusing on the difficulties and start focusing on getting to the goal of normal life, the one we want for the new year.
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Many things that are worthwhile take effort and sacrifice, in this case effort of 4-6 weeks to put the fire out by preventing transmission, and then to be alert to any sparks by testing and tracing.
Others did it. We can do it.
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Important News from CDC on HICPAC Infection Control recommendations:
"Based on the significant interest in the draft recommendations, CDC is taking a proactive step of communicating back to HICPAC some initial questions and comments... 1/ blogs.cdc.gov/safehealthcare…
"In addition, CDC is working to expand the scope of technical backgrounds of participants on the HICPAC Isolation Guideline Workgroup .. in accordance with the Federal Advisory Committee Act (FACA) regulations and guidance.
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"The expanded workgroup and the HICPAC with the newly appointed members will review and discuss these additional considerations and guideline at the next HICPAC meeting, which is open to the public.
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"Helen Goss, from Westhill, is seeking damages from NHS Grampian on behalf of her daughter, Anna Hendy.
"The action claims the health board is responsible for "multiple failings" in Anna's treatment and care.
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"The claim alleges failings were avoidable, that they caused Anna "injury and damage", and led to her condition worsening.
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