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.
___________________________
Originally posted here on 3/21/2020.
This is my sixth pandemic/COVID-19 tangential post, and this one will be a little bit more on quarantines. Specifically, what it means to quarantine. In a previous post I wrote about why we’re quarantining, but I didn’t really get into the details. And given that I’ve been getting questions along the lines of, “Can I do THIS?” and THIS is usually something akin to, “Licking countertops at a McDonalds,” I figure this post may help.
I’m not going to do my bio every time – I’m collecting all of these posts on my website now (https://www.jasonrodriguez.com/blog-1/covid-19-a-hopefully-brief-pause-from-my-usual-content), so you can read about me there. I will say that I spent yesterday writing a six-page proposal to assist in COVID-19 response, so if that goes through I’ll probably be a bit more in the thick of this and probably have less time to write these posts. Or they’ll just get shorter! We’ll see. I will also say that you all can ask questions! I’ll even answer them in these posts if they seem relevant to the larger community. You can ask on these FaceBook posts, via email (jrodriguez@gmail.com), or through my website (https://www.jasonrodriguez.com/contact-or-subscribe).
Anyway – what does it mean to quarantine? First, let’s define some terms.
1) Quarantining is what you do when you are either susceptible (you have not yet been exposed to the virus /you can still get the disease) or exposed (you have come into contact with the virus /you are carrying the virus but you are not infectious). You can quarantine in small groups of people, but if any of those people are going out into the world and interacting with other people, you ARE NOT ACTUALLY QUARANTINING. More on that below.
2) Isolating is what you do when you are infectious. When you isolate yourself, you remove all contact with susceptible people. You have a separate room, a separate bathroom, and you do not interact at all with anyone who is susceptible. I already talked about something that adds a complication to quarantine vs. isolation, which is the initial evidence that someone infected with COVID-19 is possibly infectious for several hours before they’re showing symptoms.
In order to properly quarantine, you’re basically living with the people that you interact with. You limit the times you go out in public spaces and, when you do go out, you practice extreme precautions that include: 1) limiting the surfaces you touch with your bare hands, 2) not getting too close to anyone whether you know them or not, 3) limiting how often you touch your face while you’re out (it should be zero times), and 4) washing your hands thoroughly as soon as you get home. I’d also suggest leaving your phone home if you’re going to a grocery store or a similar place because while you’re in the checkout line, your hand will undoubtedly go from your cart to your phone to your face and…that’s how contamination works.
If your kids goes to daycare, you’re not quarantining. Your child can bring the virus home, and your child can bring the virus out into the community. If your partner is working, you’re not quarantining. Your partner can bring the virus home and your partner can bring the virus out into the community.
You can go for walks and runs and bike rides; you should go for walks and runs and bike rides! But you need to follow the rules for going outside – limit how many surfaces you touch with your bare hands, stay six feet away from people, etc. Going for walks and runs and bike rides is not the same as breaking quarantine. Exercise releases serotonin, which is crucial; it keeps your spirits up.
I participated in a study in 2007 for a [well-known group of first responders] alongside [a well-known university] and one of the questions was, “at what stage should we quarantine?” The answer was complicated. Essentially, after a single reported case, the group should quarantine in mid-sized collections of people.( I think we said 20, based on our analysis.) If they waited until there were some number of cases, it goes down to groups of five. Then three. Eventually one. This particular group needed to maintain operational readiness, so the purpose of their quarantine plan was to make sure that most of the responders would be able to attend to the public. But there is a lesson in this: the later we quarantine, the smaller the quarantine group CAN be.
Think about it this way – there are 100 people out in a fictional community. One person is confirmed contagious, and the community decides to quarantine into two groups: one group of 49 people and one group of 50 people. Now let’s say one of the remaining 99 people is also contagious, but they don’t know it yet. That person is in the group of 49 people. Well, all 49 people in that group will become sick, but the other 50 people will not become sick. That is NOT an effective quarantine model.
Let’s say they do four groups (25, 25, 25, and 24 people in each group). With that scenario, up to 25 will become sick.
If they do groups of four from the start, however, at most four people will become sick, because the contagious person will be in one of those small groups of four people. That is an effective quarantine!
Now let’s say they wait until they have 25 out of the remaining 99 people who are contagious and they quarantine into groups of four. What happens? Well, there are 25 groups (99/4 is approximately 25) and, statistically speaking, every group will have an infectious person and every single person will get sick. In that case, if they were to quarantine into groups of two, only fifty people will get sick. If they were to quarantine individually, only 25 people will get sick.
The longer you wait to quarantine, the smaller your group needs to be.
Now let’s say you quarantine for two weeks and you’re clear of symptoms – what can you do? Well, at that point you can start to introduce other folks into your life as long as you are confident that they also had strict quarantine measures as described earlier. As in, none of them went to work, their kids didn’t go to daycare, they didn’t interact with groups of strangers, etc. This is where you need to take stock of your own risk and what you’re comfortable with. Don’t be paranoid and don’t be a jerk, but also protect yourself and your family and, most critically, the greater community.
That’s all for now. It’s a really pretty Saturday here in Arlington, VA. We took the dogs for a nice walk and we’re gonna go on another one soon. Maybe even hit up a nice open field somewhere. I hope you all do the same.
Take care of your neighbors. Check in on your friends. Love you and stay safe.
________
These are my opinions and thoughts and analyses - I am not representing any government agency or my company. More disclaimers on the main page.
Shout out to Liz Laribee for editing this post for me. She usually edits my blog, and starting today she'll be editing these posts, as well. Turns out I'm getting quite a few readers, so she'll help me make this more readable.