Social Distancing and Enhancing Cleaning

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Tomas Pueyo has an excellent article about how early shutdowns reduce the spread of coronvirus COVID-19.

Each day earlier action on social distancing can a 40% reduction in disease spread. Hourly hand-cleaning is an enhancer of social distancing and will get us let us get back to re-open a bit earlier and safer. Hourly hand cleaning might achieve a 70% reduction which would be the equivalent of nearly two days of early aggressive social distancing (social distancing is ultra-strict travel restrictions and shutdowns. All people following self-quarantining as close as possible).

Tomas shows that Taiwan, Hong Kong, Singapore, Japan, South Korea (other than the super-spreader church) and SARS impacted countries acted very early and are seeing over ten times better containment.

China did pretty well. They had 1800 teams of 5 people each tracking and containing the contacts of every infected person that was identified. Everybody they got interacted with, then everybody those people interacted with, and isolating the bunch. That’s how they were able to contain the virus across a billion-people country.

The US administration’s ban on European travel is good: It has probably bought us a few hours, maybe a day or two. But not more. It is not enough. It’s containment when what’s needed is mitigation.

Taiwan has had the best procedures which will be reviewed in a follow-up article.

The countries that are prepared will see a fatality rate of ~0.5% (South Korea) to 0.9% (rest of China). Countries that are overwhelmed will have a fatality rate between ~3%-5%.

Containment Has Mostly Failed – We are in Mitigation

Mitigation requires heavy social distancing. The few countries that are able should still try to strive for Taiwan’s containment procedures. Taiwan is the containment model and Wuhan is the mitigation model.

Lower the transmission rate from 2.5 to 2.2, maybe 2 if we stop getting within ten feet of people and stop touching surfaces without cleaning the surface or washing hands. Getting transmission below 1 for a sustained period of time is needed to stop the epidemic.

We must skip forward to Wuhan style shutdown and aggressive contact tracing. This means national guard applied to contact tracing. 10,000 cases means about 10 million people tracking down contacts and isolating them. The manpower effort could be reduced using technology and process improvement.

We need to have hourly hand cleaning and hand washing.

Calls to Action

Mobilize national guard for contact tracing and isolation of contacts.
Skip forward to the Wuhan model of mitigation. It is about 2-3 months of serious disruption but better 100% disruption for 2 months than an ineffective 80% disruption for 2 months and then 6 months of 100% disruption.
Hand cleaning once an hour needs to be part of the consistent and simple messaging.

SOURCES – Tomas Pueyo article, JAMA and other references, Brian Wang analysis
Written By Brian Wang

13 thoughts on “Social Distancing and Enhancing Cleaning”

  2. I think that regular cleaning of your own house should become a good habit for everybody, no matter do we have a pandemic outbreak or not. You should remember, that a mess can ruin your personal life. If you're interested to know why and how, you can read this ( weblink: https://www.homoq.com/mess-ruins-our-lives/ ) informative article on the page from Homoq site. It has a lot of such helpful articles there.

  4. How do you get the odds without testing?

    And that still doesn’t help with manufacturing. Though the time to ramp up manufacture varies enormously depending on what it is. Ideally it’s something we already make a lot of. Like carfentanil or nitroglycerine.

  5. Taiwan is the containment model and Wuhan is the mitigation model.

    Miss the boat on option 1, your next step is to try for option 2.

  6. read the referenced article. The U.S. is a continent of loosely tied 50 states. We don’t have a national database of everyone’s medical data nor did we have to prepare for another SARS. And, of course, Taiwan is an island without extensive travel ties across the world.

  7. How is it Brian that Taiwan is not doing this and they are doing fine? We don’t need to mobilize the National Guard.

  8. Lombardy indicates that it takes 8 days to go from lockdown (apart from essential travel) to the plateu of new infections.

    But it will vary from country to country and from city to city. Younger kids don’t live with parents in Germany, they do in Italy. LA doesn’t have the population density of Milan.

  9. Any reduction in spreading will buy us additional time. Everyone needs to take two weeks off and just stay home.

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