I meant Costanza

And some spillage...

I’ll bring paper towels.

Spendthrift

So our illustrious Governor 💩 announces a three phase plan.

High risk counties stay phase one.

Lower risk move to phase two.

Phase three is only when there’s a vaccine or treatment......

Oh and protests are ok but concerts and church aren’t in phase 2.

Maybe the churches and concerts should call themselves protests?

That’s what I have been recommending.

seems the gradual and "safer" re-opening has improved the economy while causing only a slight increase in the numbers of infected people in most states, with some states showing an actual decline and others showing a bigger increase...

should we continue this path, or just remove all public health guidelines associated with the virus, taking a chance on opening the flood gates?

seems many experts suggest the pattern of flu-like viruses like the corona virus, is a dormant period during the summer, then a second wave as the temperatures drop...maybe a temporary full reopen wouldn't be so bad

as Trump says, "let's see what happens..."

My brother says his community and patients are just a couple are about 4-5 weeks ahead of us here in Florida
6/8/20 Situation Update; Choosing a Safe Playgroup Environment; More Guidance for Morahs

Please note that the COVID-19 information contained
in this email is up-to-date as of today and is subject to change in the future


SITUATION UPDATE:
The doctors from the Lakewood Kehilla saw two new cases of active
COVID-19 illness over the past week. The 30 or more new cases that
were reported recently in the frum media were not from within our
Kehilla. Baruch Hashem, the new cases seen in our Kehilla continue
to seem to be isolated cases and not clusters of cases. This is good
news and we hope it will stay this way. However, it does show us that
the virus continues to exist in Lakewood, and this is a reason to
maintain our continued responsible behavior. May our Tefillos and
Hishtadlus have an impact in not allowing it to take off.

---

MORE GUIDANCE FOR MORAHS (See previous email):
The necessary focus when setting up and running a playgroup is to minimize the risks of spreading COVID-19 illness from child to child. While children are generally at low risk of the dangerous effects of COVID-19 illness, we still must try to prevent daycare children from spreading the illness within the group, and bringing home the illness to non-immune parents or loved ones, especially to someone who is at higher risk of the dangerous effects of COVID-19 illness. The guidance that is provided is designed to protect the families of your playgroup children and our Kehilla as a whole.

GUIDANCE FOR PARENTS:
The most important point in assessing whether a playgroup will be a safe enough environment for your child is to consider the following question:

Does the Morah feel an achrayus to do what she can do to
minimize the risk of COVID-19 illness spreading through her playgroup?

We have provided below example questions to ask a Morah to assess her level of commitment to setting up and running a safe playgroup. Once you have a feeling about her level of commitment, you can decide whether you are comfortable sending your child to her.

Example Questions

• Is the Morah familiar with the State daycare guidelines?

• What is the Morah's perspective toward and policies regarding:
- Limiting close physical contact between children?
- Groups size and separation of groups?
- Staff members wearing masks?
- Daily screening of children for illness, including temperature taking?

If you have specific questions regarding assessing the safety of a playgroup environment for your child, you may reply to this email with questions.

---

THE IMPORTANCE OF HANDWASHING
After you make a decision to send your child to Morah, remember that you still have one more important tool to protect yourself: Handwashing. Make sure to wash your children’s hands (and face) before they go and when they return. Washing your own hands when interacting with your children is important once they leave your home to attend playgroup. Even if your child were to pick up a virus, washing your own hands often, and trying not to touch your face, will minimize the risk of the virus spreading to you.

IMPORTANT NOTE FOR PARENTS:
The guidelines for daycare groups focus on minimizing the risk of spreading COVID-19 from child to child. However, the risk of the spread of COVID-19 is not necessarily eliminated entirely in a playgroup that is even fully compliant with the guidelines. If your child is immunocompromised, or any family member in your home is immunocompromised, elderly, or has a medical condition that places them in the high-risk category for COVID-19 illness, we do not recommend sending your child to daycare at this time. If this applies to you, please discuss the situation with us or your doctor before sending your child to daycare.

most asymptomatic coronavirus patients aren't spreading new infections
Asymptomatic spread of coronavirus is 'very rare,' WHO says

Government responses should focus on detecting and isolating infected people with symptoms, the World Health Organization said.
Preliminary evidence from the earliest outbreaks indicated the virus could spread even if people didn't have symptoms.
But the WHO says that while asymptomatic spread can occur, it is "very rare."

Coronavirus patients without symptoms aren't driving the spread of the virus, World Health Organization officials said Monday, casting doubt on concerns by some researchers that the disease could be difficult to contain due to asymptomatic infections.

Some people, particularly young and otherwise healthy individuals, who are infected by the coronavirus never develop symptoms or only develop mild symptoms. Others might not develop symptoms until days after they were actually infected.


Preliminary evidence from the earliest outbreaks indicated that the virus could spread from person-to-person contact, even if the carrier didn't have symptoms. But WHO officials now say that while asymptomatic spread can occur, it is not the main way it's being transmitted.

"From the data we have, it still seems to be rare that an asymptomatic person actually transmits onward to a secondary individual," Dr. Maria Van Kerkhove, head of WHO's emerging diseases and zoonosis unit, said at a news briefing from the United Nations agency's Geneva headquarters. "It's very rare."

Government responses should focus on detecting and isolating infected people with symptoms, and tracking anyone who might have come into contact with them, Van Kerkhove said. She acknowledged that some studies have indicated asymptomatic or presymptomatic spread in nursing homes and in household settings.


More research and data are needed to "truly answer" the question of whether the coronavirus can spread widely through asymptomatic carriers, Van Kerkhove added.


"We have a number of reports from countries who are doing very detailed contact tracing," she said. "They're following asymptomatic cases. They're following contacts. And they're not finding secondary transmission onward. It's very rare."

If asymptomatic spread proves to not be a main driver of coronavirus transmission, the policy implications could be tremendous. A report from the U.S. Centers for Disease Control and Prevention published on April 1 cited the "potential for presymptomatic transmission" as a reason for the importance of social distancing.


"These findings also suggest that to control the pandemic, it might not be enough for only persons with symptoms to limit their contact with others because persons without symptoms might transmit infection," the CDC study said.

To be sure, asymptomatic and presymptomatic spread of the virus appears to still be happening, Van Kerkhove said but remains rare. That finding has important implications for how to screen for the virus and limit its spread.

"What we really want to be focused on is following the symptomatic cases," Van Kerkhove said. "If we actually followed all of the symptomatic cases, isolated those cases, followed the contacts and quarantined those contacts, we would drastically reduce" the outbreak.

Correction: An earlier headline should have said most asymptomatic coronavirus patients aren't spreading new infections. The word "most" was inadvertently omitted.

Saw that.... That's very good news.

There was a lot of concern that this would be nearly uncontrollable with the number of asymptomatic people who will go out and about.

GREAT news!

So is everyone not dead in three weeks now?

Just you HD... Just you

For Bucky

Looks like WHO is receding a bit from it's opinion above. Don't know exactly to what extent. OOPS!

It is great news! If asymptomatic and presymptomatic transmission are neglegable we can beat this thing.

I have decided to renew and reacces my response to the pandemic on or around July 1. That gives plenty of time for me to figure things out. I am proceeding with caution, perhaps too much for some here.

They are walking that back.Coronavirus: Asymptomatic transmission still an 'open question'

BBC

How much coronavirus transmission comes from people with no symptoms is still a "big unknown", a World Health Organization scientist has clarified. Dr Maria Van Kerkhove said on Monday it was "very rare" for asymptomatic people to pass the disease on. But she has now stressed this observation was based on a relatively small set of studies.

Evidence suggests people with symptoms are most infectious, but the disease can be passed on before they develop.

Although a proportion of people test positive with no symptoms, it is not known how many of these people go on to infect others.

Dr Van Kerkhove said the evidence she had been discussing came from countries that had carried out "detailed contact tracing",

Looking at investigations of clusters of infections from various countries, she said that where an asymptomatic case had been followed up it was "very rare" to find secondary infections among their contacts.

But she it was still a "big open question" as to whether the same was true globally.

The uncertainties involved emphasise the importance of lockdown measures in "massively reduc[ing] the numbers of people infected," said Prof Liam Smeeth, an epidemiologist at the London School of Hygiene and Tropical Medicine.

He said he had been "surprised" by the WHO statement but had not seen the data it was based on.

Director of the WHO's health emergencies programme, Dr Michael Ryan, said he was "absolutely convinced" asymptomatic transmission was occurring, "the question is how much".

Dr Van Kerkhove, the WHO's head of emerging diseases, made the distinction between three categories:

People who never develop symptoms (asymptomatic)
People who test positive when they don't yet have symptoms - but go on to develop them (pre-symptomatic)
People with very mild or atypical symptoms who do not realise they have coronavirus
Some reports distinguish between these categories while others do not and she said this, along with the relatively small groups of people studied, make it difficult to draw firm conclusions.

But Dr Van Kerkhove said the weight of evidence suggested people who never develop symptoms did not play a significant role in passing on the virus in the locations studied.

Studies which tested samples of the population to find asymptomatic cases, and then traced their contacts, found far fewer secondary infections than in the contacts of people who'd had symptoms.

This led the WHO, in guidance on wearing masks published at the weekend, to conclude: "The available evidence from contact tracing reported by member states suggests that asymptomatically-infected individuals are much less likely to transmit the virus than those who develop symptoms"

The mystery of 'silent spreaders'
What is the k number?
In England, the Office for National Statistics (ONS) has been regularly testing a sample of the population.

It has found that, of those who have so far tested positive for Covid-19, only 29% reported "any evidence of symptoms" at the time they were tested, or at the previous or following visits.

People with symptoms 'highest risk'
Contact-tracing studies from a number of countries suggest that while "true" asymptomatic cases "rarely transmit" infection, transmission can occur before or on the day symptoms first appear when they may be very mild, according to Prof Babak Javid, an infectious diseases consultant at the University of Cambridge.

People can have detectable amounts of the virus in their system roughly three days before developing symptoms and appear to be capable to passing it on during this period, especially the day before or on the day symptoms begin.

Pre-symptomatic transmission has "important implications" for track, trace and isolation measures, Prof Javid said.

Under the terms of the contact-tracing schemes now operational across the UK, someone who passed on the infection while pre-symptomatic could still have their contacts traced once they developed symptoms. Someone who never experienced symptoms wouldn't trigger the same process.

While people without symptoms do seem to be capable of infecting others, current evidence still suggests people with symptoms are the highest risk.

A positive result alone doesn't tell you how much of the virus someone has in their system. And this - what is known as the viral load - along with whether an infected person is sneezing and coughing and what kind of contact they are having with other people, influences how likely they are to pass the illness on.

Dr Van Kerkhove pointed out since coronavirus mainly "passes through infectious droplets", it is when people are coughing or sneezing that they are most able to transmit the disease.

Fauci Warns That the Coronavirus Pandemic Is Far From Over
The New York Times

In a wide-ranging talk to biotech executives, Dr. Anthony S. Fauci delivered a grim assessment of the devastation wrought around the world by the coronavirus.

Covid-19 is the disease that Dr. Fauci always said would be his “worst nightmare” — a new, highly contagious respiratory infection that causes a significant amount of illness and death.

“In a period of four months, it has devastated the whole world,” Dr. Fauci, director of the National Institute of Allergy and Infectious Diseases, said on Tuesday during a conference held by BIO, the Biotechnology Innovation Organization. “And it isn’t over yet.”

His discussion with a moderator was conducted remotely and recorded for presentation to conference participants. Although he had known that an outbreak like this could occur, one aspect has surprised him, he said, and that is “how rapidly it just took over the planet.”

An efficiently transmitted disease can spread worldwide in six months or a year, but “this took about a month,” Dr. Fauci said. He attributed the rapid spread to the contagiousness of the virus, and to extensive world travel by infected people.

Vaccines are widely regarded as the best hope of stopping or at least slowing the pandemic, and Dr. Fauci said he was “almost certain” that more than one would be successful. Several are already being tested in people, and at least one is expected to move into large, Phase 3 trials in July.

But much is still unknown about the disease and how it attacks the body — research that Dr. Fauci described as “a work in progress.”

He said that he had spent much of his career studying H.I.V., and that the disease it causes is “really simple compared to what’s going on with Covid-19.”

The differences, he said, include Covid’s broad range of severity, from no symptoms at all to critical illness and death, with lung damage, intense immune responses and clotting disorders that have caused strokes even in young people, as well as a separate inflammatory syndrome causing severe illness in some children.

“Oh my goodness,” Dr. Fauci said. “Where is it going to end? We’re still at the beginning of really understanding.”

Another looming question, he said, is whether survivors who were seriously ill will fully recover.

He described the pandemic as “shining a very bright light on something we’ve known for a very long time” — the health disparities and the harder impact of many illnesses on people of color, particularly African-Americans.

The coronavirus has been a “double whammy” for black people, he said, first because they are more likely to be exposed to the disease by way of their employment in jobs that cannot be done remotely. Second, they are more vulnerable to severe illness from the coronavirus because they have higher rates of underlying conditions like diabetes, high blood pressure, obesity and chronic lung disease.

Given the disparities, he said, it is essential to focus more resources to control the coronavirus in the areas with high-density African-American populations. But the longer-term solution will take decades, he said, to address the socioeconomic and dietary factors that contribute to so many of the health problems in racial and ethnic groups that have been most affected by the virus.

The global race for vaccines and treatments by myriad companies and governments has led to calls for nonprofit and government-payment methods to ensure that the drugs would be widely available.

While access to vaccines will be essential, Dr. Fauci said it would probably not help if the U.S. government tried to impose price controls on drugmakers. “If you try to enforce things on a company that has multiple different opportunities to do different things, they will walk away.”

He said he had never seen a successful attempt at price controls, and it would be more effective for the government to work with companies and help them in developing products. Then, he said, companies “will in good faith make it available to those groups, countries, nations that really can’t afford it very well.”

“It’s a profit-driven industry,” he said, adding that companies cannot realistically be expected to give products away.

“You’ve got to have some degree of profit,” he continued, “as long as it isn’t in such an outrageous way that it makes something completely out of the realm of people who need it.”

The U.S. government has already pledged billions of dollars to several companies developing vaccine candidates. Efforts are also underway in Europe and China.