GRAND REOPENING - COMING SOON - RIGHT HERE!!!!

Well, after all those quickly executed shutdowns and lockdowns, it was inevitable that we would need to have reopenings, but hopefully they would be orderly and well-planned. I first asked myself about this on 3/29/20, and I'm glad I did. Since we luckily avoided having everywhere in crisis, every state had some spare capacity to start planning reopening. Now some of those plans are being released and going forward. This is something to celebrate, though in a sober manner with good social distancing and hygiene practices. Yes, we dodged a bullet, and didn't have the level of outbreak that northern Italy had. Congrats to us and the people who urged wise steps.

So here are a somewhat random assortment of reopening plans. The first one out of the gate was Georgia. Not well organized, but instead managed like a political football. Trump was encouraging opening (LIBERATE!) as soon as possible, and under threat from mass protests, though the mass protests didn't actually happen. In that atmosphere, Georgia went big and bold, which means foolhardy. Trump then reversed his support and mildly criticized the plan, which I think is going ahead anyway.

Texas is being more cautious than Georgia with a phased plan to open stores, restaurants, libraries, museums, and theatres at 25% capacity starting on May 1. The second phase starts on May 18. Counties with 5 or fewer cases can open at 50% capacity.

Mike DeWine, governor of Ohio and a leader in taking charge and not waiting for Trump, sets out some conditions based on hygiene and social distancing. However, he backed down on face coverings 'cuz Merrikans don't like them. Also, the plan was to coordinate with other regional governors, but Michigan's governor hadn't put together a plan in time.

The leadership by the federal government is minimal, as it generally has been, except when it comes to underwriting programs (mostly for businesses). The federal guidelines expect the states to set up testing, tracing (sure!), supplies of protective equipment, etc. Well, if states have all that responsbility, the federal government can shove their guidelines where the sun don't shine.

Well, interesting times. Stay tuned for sure!

THIS WILL BE A DEFACTO CLEARINGHOUSE FOR REOPENING POSTS, COMMENTS, AND UPDATES.

Image: wtol.com

Extras. How New Mexico avoided disaster. New Mexico again, but the epidemic is heavy in Gallup and the Navajo lands, with good video. A critique of how New Jersey handled its shutdown--Hoboken did it early and provides evidence of the doubling time being around 3 days.  New Zealand (yes, I know, not a state in the US) did great. Hokkaido (northern Japanese island) opened to soon and too aggressively and had to close again.

Views of workers in the US about safety and other issues.

Still new cases, still new hospitalizations. Why is this happening during the shutdown? Answer: Many are essential workers.

Florida has plans for major theme parks to reopen, but their management doesn't seem quite so eager.

Surge of covid cases in Texas, located in the panhandle. How will this go? On 6/26/20, the governor had to close bars back down. Also no elective surgery in the most populous counties. Very typical epidemiological measures.

A region in China sees about a dozen new cases, and they lock it down.

Missouri and Maryland had packed venues during Memorial Day weekend. Will we be seeing the consequences in a month or two? Bars in Texas were allowed to reopen, and the mayor of Houston is worried.

California has had a rather tight lockdown, but cases haven't slowed. What to do next?

The governor of N. Carolina (a dem) has slowed down the reopening and is telling people to damn-well wear a mask.

An article focusing on psychological reactions and why liberals and conservatives aren't responding the same to covid-19.

A lot of southern states are seeing surges in covid cases. How will this affect the presidential election? This includes Texas. More information about cases in southern Texas and half of Florida. How Texas fumbled its reopeening to create a surge of cases. When medicine and politics clash, some politicians are going to prioritize their candidates and their parties. Kelly Anne Conway makes Trump the cautious sage of reopening?!?!

Battles over school reopenings in Texas and California. Of course it's going to happen. Sickout by teachers and staff closes Arizona schools. 

And then the colleges... Lots of unnecessary mixing by college students doing the party thing. Lots of colleges. I couldn't list them all. 

Anti-mask militants get angry in Idaho. Yes, the absurdity of the existence of militants against masks. 

And a hair salon owner sets up and embarrasses Nancy Pelosi. And denies she set up Pelosi while appearing on Fox News. I'm not falling for that. 
 

And as summer ended and cool weather came, so did a surge in covid. This isn't unexpected for a respiratory virus. Increases nearly everywhere, and surges in some places. Here's a surge in El Paso TX.

Evidence-based medicine--Ebola edition

So at least two nurses caught Ebola from the Liberian patient cared for in Dallas. What does that tell us?

We already knew that cautious, well-trained American professionals could contract the disease because it happened with the American missionaries, including a doctor. Many African medical professionals have caught and died of Ebola too.

The right way to handle it

In contrast, three Ebola patients have been cared for at Emory University Hospital without a transmission. What does that tell us? That Emory knows how to handle this disease better than the Dallas hospital does. There must be important differences in how the personnel gown or perform tasks, and Emory does it in a superior way. So learn from Emory.

Also, it makes sense for current and future Ebola patients to go the Emory for treatment rather than have the treatment administered at a lesser hospital. We didn't know this beforehand, but we shouldn't be surprised. We did get a warning from African hospitals that were trying hard to prevent transmissions, but still failed. We had another warning from the Spanish nurse who caught the disease.

Luckily, the medical administrators (whoever they are) see the evidence too. One of the Dallas nurses has been flown to Emory. The other is quite healthy and was staying in isolation at the Dallas hospital, but has just been transferred to Maryland. Since she remains well, she probably doesn't require extensive care with lots of handling of bodily fluids. There's little chance that she'll infect someone else.

There's more luck too. Among the exposed civilians in Dallas, there are no reports of any developing the disease... so far. What a relief.

No abundance of caution

Another thing we learned is that the Dallas hospital wasn't careful enough. They didn't wear higher level protection gowns for the first two days of isolation despite the high chance that the patient had Ebola. They had a large number of staff caring for the patient instead of a small dedicated team. They didn't provide housing for this dedicated staff, who mingled with family. The second infected nurse even flew to Ohio and back again.

The Dallas hospital acted was though their precautions were 100% fail safe. That was an incorrect assumption and a stupid risk to take. A smarter approach would have been to limit the number of people exposed and limit their contacts with others. Finally the Dallas hospital is doing this. This precaution should have been implemented at the beginning. But at least they're learning instead of being in denial.

We still have to wait to see what happens with the exposed people in Dallas. Now we have to wait even longer to find out whether any relatives or fellow travelers caught Ebola from the second nurse. Those later exposures should never have happened. Instead of finding out around Oct. 19 whether we face a larger epidemic, we won't know until after Nov. 4. We didn't need this extra stress.

Possibly flying Ebola to your destination

Image: latimes.com

Extra. Read about and marvel at the facilities at Emory. Only three definite cases of Ebola have been imported to other countries (Nigeria, Senegal, and the US). Nigeria had the worst situation, but they have stopped the spread and ended the crisis. It never spread in Senegal. We'll have to see what happens here in the US, and also what happens elsewhere. Our response needs to be based on evidence and reasonable caution, not panic.