We talked to my sister-in-law in New Zealand on Sunday (her Monday). It was her kids' first day back at school. They're back to fairly normal school, which is safe because New Zealand has their outbreak well and truly under control: they have long stretches with no new cases. There was one new case report this week, but it was associated with one of the known clusters. There are no cases that they can't trace the source of, so they are confident that they've notified all contacts and they're isolating.
On Tuesday, I read the CDC's guidelines for schools reopening here in the US. These are just guidelines, and each school district is going to have to work out what makes sense in their specific situation. But I think it is likely that my kids will not be going back to "normal" school when they go back to school. I think this will be the right choice, but I am very sad about it. Both of my kids had an outburst/meltdown about how school is right now this week. I can't argue with them. School right now is not good. Our district did a good job setting something up in a very short period of time. But this is not a good way to do school. I am sad for what we're asking our children to sacrifice, and sad to know that we'll have to ask for more sacrifices.
We talked to my husband's parents last night and also one of his best friends, who is in Auckland. They were all shocked to hear my report on how our county is doing - when I told them we're averaging 100-150 new cases a day, they thought that was for the whole of California, not just San Diego county. I haven't been tracking the numbers for all of California, but I just looked it up and we had more than 2000 new cases yesterday.
Meanwhile, people here are surprised when I tell them that my in-laws aren't under guidance to wear masks. There is no real reason for them to wear masks, because there is very little risk they'll run into someone who is infected.
Against that backdrop, I've been very busy at work, both because my own projects are busy and because I've been helping pick up some slack for some of the people whose childcare situations are more challenging than mine. And household chores remain more time, thought, and energy consuming than usual. I also feel like my local leaders are spending all of their efforts on how to open businesses, and not enough effort on providing people with guidance on how to safely do things that might help us emotionally, like see friends. This leaves us all to figure out what is OK to do on our own, with no official guidance. If you take that responsibility seriously (which I do), that is just more work to do.
So anyway, I was worn out and had a bad week. Luckily, I had planned to make this a four day weekend. I took yesterday off. I had a short to-do list to start the day and then I read in my hammock, went for a walk on the beach with Petunia, and picked up ice cream with the kids. It was a nice day. A couple more like it and I might start to feel less worn down! We'll see how the rest of the weekend goes.
Anyway, on to the links:
In the comments on last week's post, my friend Autumn asked if I had any good links for the effectiveness of cloth masks. I was in the midst of the crappy week I whined about above, so I didn't go look them up but promised to post some today. Here's what I have:
Bob Wachter, the UCSF doctor who has been doing daily Twitter threads with his observations about COVID-19 and other related information, took his thread about masks and converted it to a Medium post. There are links in there to the data on masks and also a reproduction of the graphic that shows an analogy to someone peeing on you (yes, really). If you are only going to read one thing about masks, that's the one I'd pick.
Cleveland Clinic also has a nice summary of the evidence and the recommendation about masks.
And here is a Medium post by a researcher in Singapore about masks that I read a month or so ago. It was probably what convinced me that cloth masks were worthwhile, even before the official guidance here changed.
In reading all of these things, I think it is important to keep in mind that our best evidence right now is that most SARS-CoV-2 transmission is via droplets, not aerosols. (Here is an article from March that does a good job of explaining what that difference means.) Almost any face covering is going to reduce the amount of droplets getting out of your mouth, because droplets are relatively big. Medical workers clearly need PPE that can protect against aerosols, because there is evidence that some medical procedures can produce SARS-CoV-2 aerosols. People who have to work all day around other people (bus drivers, grocery store workers, etc.) should ideally get medical grade masks, and failing that I would spend some time research which cloth masks will do the best job of protecting against inward transmission.
The rest of us should think most about stopping outward transmission and can probably use just about any cloth covering as long as we're keeping our distance from others. My personal decision has been to look for masks that work well in the various situations we need them. I'm finding that what works well when I'm shopping isn't what works best when I'm walking on the beach, for instance.
Depending on what things look like in a couple of months, I may end up doing research on the best type of cloth to use in masks to protect the kids at school. But for right now, my focus is on experimenting with designs to find what styles work best for us all.
Speaking of which... here is what ended up working best for Petunia, whose ears were too floppy to hold a mask. I sewed two buttons onto one of her headbands. She wears the headband and loops the mask around the buttons. She can do that on her own, which makes this a better option than the mask extenders we tried because she needed help to get her mask on with those.
On this weekend's to do list: Order more stretchy headbands so that I can make her several of these.
OK, on to the other links.
Ed Yong wrote another great article on COVID-19, this time on our patchwork response.
I also found this Science article about the details hidden beneath the average R0 really useful.
I am concerned by the reports coming out about a Kawasaki-like disease in young COVID-19 patients. Washington Post has an article about the fact that they're seeing it in young adults as well as children and Science has a good article summarizing what we do and do not know about SARS-CoV-2 infections in children. Taken together, these two articles make me want us to be more cautious about reopening things. There is a lot we don't know and I think a lot of people are making assumptions about the safety of opening schools without first controlling the local outbreak that don't acknowledge the huge gaps in our knowledge.
Speaking of reopening things... my county opened up restaurants and retail stores. I have mixed feelings about this and we don't plan to change our behaviors with respect to restaurants or stores anytime soon. We'll do takeout and look for curbside pickup options.
Clearly, not everyone in my area is feeling so cautious... the county has already shutdown one establishment for violating the rules.
Here's what violating the rules looked like:
Meanwhile, we still can't go to most of our big public parks, like Mission Bay or Balboa Park. And I am really struggling to see why the official rules say it is safe to sit in a restaurant 6 feet away from people you don't know but not safe to sit on a beach 6 feet away from people you don't know. Maybe it is just that we don't have the resources to enforce the distancing in the big public areas, but can tell restaurants to enforce distancing? I don't know.This were taken just yesterday.— Covid Bryant❁ (@blogboyzHQ) May 22, 2020
@ El Prez
(Pacific Beach/ San Diego, CA) pic.twitter.com/SpislYMway
I think this story illustrates some of the challenges for my region: San Diego hospitals are taking COVID-19 patients from Imperial County because their hospitals are getting overwhelmed. Why are their hospitals getting overwhelmed? It is a rural county without a lot of hospitals, and Americans living in Mexico are coming home if they get sick. El Centro, CA is right across the border from Mexicali, which is the capital of Baja California. There were stories here early on interviewing Americans living in Rosarito (a beach town not far south of Tijuana) who essentially said that was their plan: Stay in Mexico unless they got sick, in which case they'd cross the border.
I found this essay about why evangelicals are pushing for a faster reopening really interesting.
This essay about women on Tik-Tok figuring out how to satirize Trump is also really good.
This is a really succinct statement of what we gain from contact tracing beyond being able to isolate people who may be infected:
This made me smile:Important point. Good contact tracing means a better understanding of transmission, which can in turn lead to more effective and efficient control measures. https://t.co/w9TBgbCZd3— Adam Kucharski (@AdamJKucharski) May 22, 2020
I love this:Last week, while Zoom-ing with a group of students, I witnessed something that made me jump!— Dr. David Shiffman (@WhySharksMatter) May 18, 2020
A student seemingly reached from their Zoom box into the Zoom box of the student next to them and shoved them!
Turns out they were siblings in the same house, just on different ipads.
Mr. Darcy was RICH:The cafe at Izu Shaboten Zoo in Shizuoka, Japan uses stuffed Capybaras to enforce social distancing— Spoon & Tamago (@Johnny_suputama) May 21, 2020
(Photos by @chacha0rca) pic.twitter.com/g15HTL2IG0
How rich by today's standards were Jane Austen's characters? Millionaires and billionaires. This chart is great and it hammers home an important point: although Austen's stories are popular today, they don't present a true picture of life in the early 19th century. https://t.co/4NDXne8JHJ— Hallie Rubenhold (@HallieRubenhold) May 20, 2020
Here's your weekly rabbit:
Have a good weekend, everyone!Young Rabbit on the Somerset Levels.😍— Carl Bovis (@CarlBovisNature) May 22, 2020
Rabbits are extremely wary animals, even young ones.
As you might be able to tell, I was laying on my belly to get this shot
Quite uncomfortable, but worth it when this Kit ran out in front of me & posed briefly😊#TwitterNatureCommunity pic.twitter.com/7LYvL5eXtg