Wait - why is Jason talking about COVID-19? And why are these written like FaceBook posts? There’s a longer explanation here but the short version is that my day job for the past 15 years has been developing models of human health effects and medical response for chemical injuries and biological illnesses, including pandemics. I’ve been making these posts on FaceBook and I was asked to put them in a more shareable manner. I’m linking to the posts on the explanation page. These are the original, unedited posts. I’ll continue until I run out of things to say.
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Originally posted here on April 21st.
Hello family and friends. Sorry for the delay on this one. I got real busy. I always start these posts by basically saying, “I’m not working COVID-19 analysis but I have fifteen years experience on human effects and medical response modeling for large scale events and yada, yada, yada,” but then I spent a bunch of days doing an INTENSE series of analyses with very little sleep and I can’t say that anymore. I will say that, now more than ever, my opinions are still my own, and do not represent any government agency or my employer.
There were a bunch of takeaways from the analyses, but the main one for all of us is, “You should 100% be wearing a mask while indoors while with people you are not quarantining with.” I’d say it’s less important to wear one outdoors, but that depends on your risk comfort level, the law in your area, and how careful you are when you’re outside. If you’re going to be around other people, and not just in your backyard, wear a mask.
And, of course, how your locality is handling the pandemic. Which is going to be the main thrust of today’s article, because a conversation I’ve been having very often with friends is, “When can I see people again?” And that answer changes depending on the friend, their circumstances, and where they live.
Way back on March 21st which was A MONTH AGO I wrote about how you quarantine, with a little bit towards the end about how you can expand your quarantine. Now I think it’s time to talk a little bit more about expanding your quarantine. What do I mean by expanding your quarantine? I mean that you’re still living in quarantine, but maybe you begin meeting face to face with certain folks on occasion. That’s right...actual socialization, an important aspect of maintaining wellness.
There’s really no hard-and-fast rule, but I personally like to look at it as three different risk factors:
What is their routine, and do you believe what they’re telling you? You know what you’ve been doing, but you should have a real discussion with your friends about what they’ve been doing. And then you should ask yourself a really hard question that may shape your future interactions with this friend: “Do I trust that this person is being completely open about what they’ve been up to?”
Some folks just don’t care. They don’t! We include these people in models! Noncompliance, it’s a modeling factor. They think the worry is overblown, but they also likely understand that quarantining right now has some social capital associated with it. So they may tell you that they’ve been properly quarantined for two weeks but they won’t tell you that they’ve actually been going to the office, or hooking up with someone who doesn’t live with them, or they were at a barbecue last weekend, or whatever else.
Other folks just don’t understand. There’s only five people at the office. Yeah, they hooked up with so-and-so but they’ve been quarantining too. Yeah, they went to a barbecue but everyone stayed six feet away from each other. You gotta ask these tough questions and then really assess the openness and carefulness of your friends. Because a presymptomatic or asymptomatic infectious person can straight-up ruin all of the work you’ve done AND, if you are now co-mingling with other folks, break into their group as well.
These are the days of tight knit, trustworthy groups.How high risk is their job? Some folks are simply being forced into risky positions. Let’s not beat around the bush, here. Nurses and doctors, yes. Also grocery store workers, delivery folks, etc. I’m going to say two things about these folks, because it’s important:
a) You can call them a hero, but you also better be slipping them some extra cash because their employers aren’t doing enough. We’re tipping 50% on all takeout and delivery. We get our groceries delivered and tip well, but if you’re in line at the supermarket and don’t have cash on you, buy your cashier a gift card to the supermarket. No one has to know.
b) If you expand your quarantine group to folks with high risk jobs, you are exposing yourself. It sucks, because those folks need social interaction as much as everyone else and, if given the choice, many of them would take a job that would allow them to stay home and not take these additional risks...but you can’t risk other people’s health along with your own. If you expand your quarantine to someone with a high-risk job, that is the end of your expansion. You can’t also meet up with other folks. You need to act like you’re exposed, and you need to tell people that.
This is the worst possible time to get this illness. But make no mistake, absent a vaccine, MOST of us are going to get this illness eventually. It’s too wide-spread right now to die out like SARS did. Back in late January, when asked about this disease, I told folks, “You’re probably going to get it. You’re going to want to get it RIGHT NOW or in six months.” We are in the period where you do not want to get it. Bringing extra risk into your life is your choice, bringing it into someone else’s is also your choice...but it should be their choice. Just try to keep that in mind.Where do you live? NYC is doing a great job considering where they were a month ago - but it’s still not the best place to be right now. A high volume of infectious people partially negates the quarantining, because the public spaces you walk through are littered with contamination. The supermarkets and the subways - you can try to make them cleaner but they are still risky, and those risks could easily be transmitted to other folks. In those situations, I’d suggest still being hyper-vigilant of symptoms. Take your temperature at least once a day, don’t be hasty to blow off your coughing as allergies or assume that a modest temperature increase is no big deal. If a person passes the first two risk factor tests (quarantined/trustworthy and low-risk job), then they can still be part of your expanded group...but we all need to be extra careful and not allow ourselves to become too comfortable. We all gotta be honest with each other.
If you’re in a city that’s experiencing an upswing (or a city where folks are protesting stay-at-home orders), that’s a truly dangerous city. That’s a city where folks are not being vigilant, are walking around while contagious, and are potentially adding MONTHS to their own cities’ strict stay-at-home time. In those situations I wouldn’t suggest expanding your quarantine group AT ALL. It is impossible to accurately assess the risks. You have to assume a significant amount of people are being reckless, and you have to assume everything you touch is contaminated.
I know that sucks but, honestly, so do the people who are making this harder for everyone involved.
Anyway, those are my personal rules for expanding quarantine. Someone may have their own. I’ve spent my entire career developing models to weigh personal risk against population risk, and this is what I’ve come up with. But please, feel free to ask questions. I’m around, I now know A LOT more about COVID-19, I can answer as best I can, and I’ll tell you if I don’t know the answer to a question.
Stay safe, y’all. Spend money locally and safely. Give to your local charities if you’re still working. REMEMBER - there are people who need extra help right now who also DON’T have internet access or who can’t ask for help because of their living situation. Try to find those charities. So far I’ve made donations to:
The Arlington Food Assistance Center because getting groceries to folks who can’t afford groceries in a time when no one is donating food is difficult!
Doorways for Women and Families - because there are people quarantined with abusive partners who need extra help!
Thrive Arlington - because providing emergency financial assistance for the underemployed, unemployed, and ill is of particular importance right now!
I’m sure you all have similar places in your communities. Give to them, please. Tip your service people double what you normally would. Find Patreons and Kickstarters to donate to. Take care of your neighbors. Wash your hands.
Love yas!
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These are my opinions and thoughts and analyses - I am not representing any government agency or my company. More disclaimers on the main page.