I don't see how increased traffic/travel as we're starting to see [2] will do anything other than increase transmissions.
[1] https://projects.sfchronicle.com/2020/coronavirus-map/ [2] https://www.sfchronicle.com/bayarea/philmatier/article/Bay-A...
If the strategy is actually suppression and elimination, then the lockdowns are not working (at least not here in Oregon, where daily number of new cases have been flat for about 2 weeks; I'm not sure what things look like in California).
If it were remotely possible to precisely control the transmission rate such that we stay just under hospital capacity, there would at least be a coherent argument for this. I'd disagree, since a huge part of slowing the spread is to buy time for other mitigation options, such as therapeutics, contact tracing, etc. That said, it has been immensely frustrating that CA and SFBA leadership hasn't provided more clear guidance on what, exactly, we're waiting for.
No, we're still avoiding surging past healthcare capacity, which shoots the fatality rate for both the disease itself and anything else that competes for resources with it way up. That's the point.
It's true that on some places we may not need SIP to remain in the safe zone, but one of the big problems is that we don't have the kind of surveillance that lets us even be clear what the likely course is, because we're still mostly testing only the very sick because of limited testing availability and infrastructure, which means we have no good future window, and we won't be able to restore SIP in time to prevent a surge because by the time we see it in the case numbers the infections that will take us beyond capacity will already have happened.
That's one of the reasons establishing better surveillance is one of the keys to reopening identified by (among others) the West Coast group of states coordinating on the issue.
The strategy is basically, in order:
1. Reduce the rate of transmission to avoid overwhelming hospitals (which would increase the fatality of all other illnesses/injuries). When we have no reliable testing infrastructure, the only action we can take is sheltering-in-place as much as possible
2. This buys time to increase medical supply chain capacity and stockpile necessary supplies. This increases the amount of cases the system can handle, which is important when the public policy feedback loop doesn't see new cases until they're in the hospital weeks later
3. At the same time, build testing infrastructure to detect infections before they turn into uncontrollable outbreaks. This will hopefully catch cases before they get to the hospital, shortening the public policy feedback loop
4. At this point, we should be able to resume some moderate amount of activity without being completely in the dark. We will likely see a cycle of one week on, one week off, two on, two off, etc as we see how much we can control the rate of spread. This will increase herd immunity, but will likely require months to spread the infection without overwhelming our health system
5. All throughout this time, high risk populations will have to isolate as much as possible, since they cannot be infected safely. Medical companies will be working on a vaccine, but it will probably take closer to a year before they are ready for the market.
The issue I have is that if we overload our medical system - just go on twitter to see the horror stories posted about ICUs and medical staff in serious depression - then even if you have a totally managable non-COVID acute issue, you could get infected or die by lack of treatment because the system is at or beyond capacity.
We are in a fight to keep our current medical system running. If you overload it recovery for that may take longer than the hypothetical herd immunity or vaccine.
For curves: Flat = working. exponential = not working.
600 to 1000 tests per day in 2 weeks
They might have gotten hit by a glitch where Santa Clara didn't report for 3 days.
