OT: Corona virus

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ORIGINAL: Chickenboy

ORIGINAL: geofflambert

Not knowing is a problem. Not testing is not an answer to that problem. Random testing could at least provide us with scientific wild-ass guesses but we're not even doing that. The testing we are doing is ad hoc and incomplete. New York recently added thousands of deaths as being "likely" related to the coronavirus. "Flattening the curve" buys us time, but only if we actually do something with that time, like produce more tests by a factor of 1,000 or more. Just waiting until everyone eventually is infected and the survivors may or may not be immune before we start the world turning again is not an answer. If you're telling me that we just can't test everyone, you're telling me we didn't vaccinate virtually everyone against smallpox or that we really didn't almost eliminate polio. When we go to our doctors our medical record is checked to make sure our vaccinations are up-top-date. We regularly get tested for things like colon polyps and prostate problems. This will all get to be routine eventually. The problem we have to fix is getting to where it's routine sooner, way sooner than we're going at the current pace. We need to get to the place where any doctor anywhere can order tests and get them in a timely fashion from LabCorp or wherever. Diagnosis ---> treatment. Modellers are trying to model what is actually happening. Critics are checking that modelling against invalid data. What's the use in that?

Demanding 'more testing!' for the virus (e.g., PCR testing) from the general populace doesn't matter for stemming the epidemic curve. And (with the exception of the triage example above) it hardly matters for the clinical patient outcome.

All that aside, I do think extrapolation of 'attack rate' data can help clarify a population's probable prevalance or at least get closer to ground truth. But that sort of testing isn't being done anywhere that I can think of. But that's another post for later.

Here is why testing is important. Asymptomatic carriers.

We make predictions about virtually everything using incomplete data. A sample size that is representative enough of a general population to "see" the infection rate on that population can help determine policy around measures to open up the economies of all of these countries. If we don't know more about actual infection rates (Ro if possible but this may not be possible to determine accurately) then we can't take useful measures.Contact tracing once cases reduce will also be needed to slow or shut down new outbreaks.

Right now countries are flattening the curve and beginning to open some parts of their cultures and workplaces.

Should all people be required to wear masks? Which masks? Only surgical? Or more?

Should all people going to work stagger travel times and work hours so that there are less in the office at any one time and less traveling at any one time?

Should restaurants and bars be allowed to reopen with some modification of existing seating or would this be both transmission ineffective and economically difficult (fewer patrons)?

Should schools open as normal or stage weeks for different ages to reduce numbers in the building?

Should all healthcare workers be tested regularly, like each week, to protect them from developing a severe infection?

I can't see any reason why extensive testing would not be an essential part of opening up any country or region after the case curve has lessened to the point reopening is being considered.

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ORIGINAL: Orm

I find it funny that Sweden both manage to get criticism for to harsh measures, and to lax measures. [:)]

It's interesting that Sweden has been able to keep a good portion of the economy open by trusting the citizens to take advice rather than mandating they do by law. This says a lot about the social responsibility of Swedes, since the result so far has not been far off other countries that are completely locked down.

I'd be interested to know though how much you see on the ground with people not heeding guidelines and engaging in more risky social gathering behaviour?

[RangerJoe]

ORIGINAL: obvert

ORIGINAL: Chickenboy

ORIGINAL: geofflambert

Not knowing is a problem. Not testing is not an answer to that problem. Random testing could at least provide us with scientific wild-ass guesses but we're not even doing that. The testing we are doing is ad hoc and incomplete. New York recently added thousands of deaths as being "likely" related to the coronavirus. "Flattening the curve" buys us time, but only if we actually do something with that time, like produce more tests by a factor of 1,000 or more. Just waiting until everyone eventually is infected and the survivors may or may not be immune before we start the world turning again is not an answer. If you're telling me that we just can't test everyone, you're telling me we didn't vaccinate virtually everyone against smallpox or that we really didn't almost eliminate polio. When we go to our doctors our medical record is checked to make sure our vaccinations are up-top-date. We regularly get tested for things like colon polyps and prostate problems. This will all get to be routine eventually. The problem we have to fix is getting to where it's routine sooner, way sooner than we're going at the current pace. We need to get to the place where any doctor anywhere can order tests and get them in a timely fashion from LabCorp or wherever. Diagnosis ---> treatment. Modellers are trying to model what is actually happening. Critics are checking that modelling against invalid data. What's the use in that?

Demanding 'more testing!' for the virus (e.g., PCR testing) from the general populace doesn't matter for stemming the epidemic curve. And (with the exception of the triage example above) it hardly matters for the clinical patient outcome.

All that aside, I do think extrapolation of 'attack rate' data can help clarify a population's probable prevalance or at least get closer to ground truth. But that sort of testing isn't being done anywhere that I can think of. But that's another post for later.

Here is why testing is important. Asymptomatic carriers.

We make predictions about virtually everything using incomplete data. A sample size that is representative enough of a general population to "see" the infection rate on that population can help determine policy around measures to open up the economies of all of these countries. If we don't know more about actual infection rates (Ro if possible but this may not be possible to determine accurately) then we can't take useful measures.Contact tracing once cases reduce will also be needed to slow or shut down new outbreaks.

Right now countries are flattening the curve and beginning to open some parts of their cultures and workplaces.

Should all people be required to wear masks? Which masks? Only surgical? Or more?

Should all people going to work stagger travel times and work hours so that there are less in the office at any one time and less traveling at any one time?

Should restaurants and bars be allowed to reopen with some modification of existing seating or would this be both transmission ineffective and economically difficult (fewer patrons)?

Should schools open as normal or stage weeks for different ages to reduce numbers in the building?

Should all healthcare workers be tested regularly, like each week, to protect them from developing a severe infection?

I can't see any reason why extensive testing would not be an essential part of opening up any country or region after the case curve has lessened to the point reopening is being considered.

I hate to bring it down to money, but cost is a factor in the testing. Plus the trained staff who are not then doing other things that they otherwise would be doing as well as the supplies for the tests. Each area and region would have to be tested and what would prevent people from moving from one area/region to another? Possibly carrying the virus that was not detected or getting the virus from the new area/region?

Health care workers as well as police/EMTs as well as others in close proximity of infected people should be tested, then treated/quarantined as needed.

[Chickenboy]

ORIGINAL: Alfred

ORIGINAL: Cap Mandrake

ORIGINAL: Alfred


When this period is calmly assessed in the future, I think you will find a timeline which shows that all the Western governments relied very much on the WHO advice that there was no evidence existed for human to human transmission. Without that particular transmission mechanism, the very costly to society steps since implemented could not be justified.

There is a vert strong argument to be made that the reason why countries like Taiwan and South Korea have done comparatively better than the West is because at no stage did they pay any attention to what WHO said. Having directly experienced the earlier pandemics which originated in China, immediately they heard of the situation in Wuhan, they activated their pandemic plans which had been developed in response to those earlier pandemics.

Alfred

Agreed. The January 14 pronouncement by the WHO that there was "no clear case for human to human transmission" is the worst scientific advice of the 21st century (so far). The only question in my mind is, was it simply scientific caution or was the WHO leadership coddling China? The evidence for the latter is very strong. There were several cases of severe pneumonia among doctors and nurses in Wuhan IN LATE DECEMBER. They had cared for the same type of patients AND they had no connection to the Wuhan wet market. This should have set off alarm bells in the WHO but it seems the Chicoms were not being totally honest. [X(][X(] I'm shocked I tell you! Even so, the locals had ALL figured it out.

The Taiwanese clearly have not the slightest concern about hurting Beijing's feelings. They have extensive business with PRC (Foxcom for example) but they have a tripwire mentality regarding potential epidemics or a Chicom attack. They also had already identified the WHO head as a Beijing call girl well before COVID.

In order for containment to work...there needed to be a total, universal ban on flights from China by early January. The thermometer check at the airport thing was complete bullshit.

Cap Mandrake,

I think you will find this recent report

https://henryjacksonsociety.org/wp-cont ... sation.pdf

very illuminating. It provides a detailed timeline of all the actions taken by the Chinese authorities to cover up their culpability and the gullibility of the WHO. Also detailed is how the UK's special committee (Nervtag) tasked with providing advice to the Chief Medical Officer and ultimately to the UK Department of Health and Social Care was misled to provide poor advice throughout January 2020. Quite a different perspective from the salacious charges made against the UK government by the Sunday Times.

The study concludes that China was in clear breach of its legal responsibilities under the 2005 International Health Regulations.

Alfred

Good article, Alfred. I will be keen to follow the (hopefully) international response(s) in the coming years.

[Canoerebel]

Germany beginning to ease countermeasures too, re-opening stores: https://www.msn.com/en-us/news/world/ge ... r-BB12QVsX

[Chickenboy]

ORIGINAL: obvert

Here is why testing is important. Asymptomatic carriers.

As I said earlier, to date we've tested approximately 1% of the US populace. This is about where many other countries are, although some have tested 2% of their populace. South Korea has tested a lower percentage of their populace than we have to put it in perspective. Over two months.

This is by heroic back-breaking efforts by state governments, local governments and private laboratories. This level of testing has many laboratories running out of swabs, reagents, PPE for workers, VTM (Viral Transport Media), trained personnel and other things you need to run these tests. Expecting a 50-fold surge in testing is simply unreasonable and unrealistic. We must apply judicious selection of who we test for the virus to control caseload.

For the foreseeable future, nobody-and I mean nobody-will have the resources available to do virus testing (i.e., PCR) on everybody that wants that test done-today-on every citizen that wants it done. This includes asymptomatic people that don't know they've been exposed.

Most states have pretty similar guidelines on whom to test. In Texas, there is an online Questionnaire that you can answer on a smart phone that will triage you through a flow chart. Questions such as 'have you traveled to X' country, 'do you have a fever?' or 'do you have trouble breathing?' can be answered to guide you through the Questionnaire. If, at the end of the survey you are a candidate for testing, you are given a time and place to go for testing. There's also some testing of frontline responders, medical personnel and so forth.

With all this in mind, Texas has tested 176,000 people to date. Of those, 18,000 have been positive. An 'attack rate' of approximately 10.2%. With this sampling bias-intentionally derived to identify only sick people or people that are likely to be around sick people-we're still at only 10% positives. The daily rate of change hasn't changed much in the last two months (it's been consistently between 8-10%)-and I've been following that very closely.

New York state has been biasing their sampling as well-testing primarily sick people or frontline responders that are likely to be around sick people. Their attack is 39.7%. It's actually dropping-at one point last month it was >50%.

By looking at the rise of fall of attack rates, you can take a stab at identifying or approximating regional prevalence in the absence of serosurveillance. It's a crude measure, but you can glean from this that New York has a much bigger problem with the virus than Texas has had or is likely to have.

Now there may be a role for pilot studies to estimate the number of asymptomatic carriers in a given population. That would be interesting. But, of course, several pilot studies would have to be performed-you can't just sample from one geographic area that may have disparate background prevalence in asymptomatics. And, at the end of the day, you will have to extrapolate your findings to the given population anyways, just simply because you can't test everyone with our existing systems.

So I guess I'm advocating for adding in some pilot studies into our existing system which is currently biased towards clinical symptomatics and frontline responders. But laboratory capacity bottlenecks for the foreseeable future and our application of scant resources towards identifying clinical symptomatics and frontline responders take prescedence.

[Chickenboy]

ORIGINAL: obvert

ORIGINAL: Orm

I find it funny that Sweden both manage to get criticism for to harsh measures, and to lax measures. [:)]

It's interesting that Sweden has been able to keep a good portion of the economy open by trusting the citizens to take advice rather than mandating they do by law. This says a lot about the social responsibility of Swedes, since the result so far has not been far off other countries that are completely locked down.

I'd be interested to know though how much you see on the ground with people not heeding guidelines and engaging in more risky social gathering behaviour?

Currently, Sweden's death rate is about 25% higher than the United States at 152/M vs. 121. When compared to Scandinavian neighbors Denmark (61/M), Finland (17/M) and Norway (30/M) it's a real standout too. I've seen some pieces fawning over the "Swedish Model" lately, but I think Sweden will wind up ruing some of their approach before all's said and done.

A good article on this:

https://www.project-syndicate.org/comme ... om-2020-04

[Cap Mandrake]

Chickenboy is right. There are numerous obstacles to testing. When the CDC relinquished exclusive testing in the US and the private and university labs started to step up we set up expensive tents and outdoor heaters and paid a bunch of staff to gown up in face masks, and N-95 masks to collect the specimens...and then we ran out of viral transport media...and then when, after all effort we finally got the specimens to Quest it took 6-7 days to get a result...and then we had only 10% positive after selecting for the sickest appearing patients.

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ORIGINAL: Chickenboy

ORIGINAL: obvert

ORIGINAL: Orm

I find it funny that Sweden both manage to get criticism for to harsh measures, and to lax measures. [:)]

It's interesting that Sweden has been able to keep a good portion of the economy open by trusting the citizens to take advice rather than mandating they do by law. This says a lot about the social responsibility of Swedes, since the result so far has not been far off other countries that are completely locked down.

I'd be interested to know though how much you see on the ground with people not heeding guidelines and engaging in more risky social gathering behaviour?

Currently, Sweden's death rate is about 25% higher than the United States at 152/M vs. 121. When compared to Scandinavian neighbors Denmark (61/M), Finland (17/M) and Norway (30/M) it's a real standout too. I've seen some pieces fawning over the "Swedish Model" lately, but I think Sweden will wind up ruing some of their approach before all's said and done.

A good article on this:

https://www.project-syndicate.org/comme ... om-2020-04

I'm not saying I think it's the method most experts advocate, but in this situation I'm more curious how it's going on the ground. Orm, or other Swedes, do you have some insight there?

In the States there are now political battles, open protests and breaking of lockdown rules all over the East coast and elsewhere. There have been tensions in many other places having had a long lockdown, like Italy and Spain, as we've heard here. It would be interesting to know how people respond to this lighter recommendation rather than a mandate.

While Sweden's death rate is greater than countries next to it, it also does have double the population and a larger, more dense capitol city as well as higher levels of immigration and diversity than Norway or Finland. Denmark Is a better measure, but still not as populous.

It is a different model to South Korea, but mainly in that testing is not as high and therefore contact tracing would not be as viable..

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ORIGINAL: Cap Mandrake

Chickenboy is right. There are numerous obstacles to testing. When the CDC relinquished exclusive testing in the US and the private and university labs started to step up we set up expensive tents and outdoor heaters and paid a bunch of staff to gown up in face masks, and N-95 masks to collect the specimens...and then we ran out of viral transport media...and then when, after all effort we finally got the specimens to Quest it took 6-7 days to get a result...and then we had only 10% positive after selecting for the sickest appearing patients.

And yet, more tests are what will get the country open again according to this.

https://www.nytimes.com/interactive/202 ... e=Homepage

As some governors consider easing social distancing restrictions, new estimates by researchers at Harvard University suggest that the United States cannot safely reopen unless it conducts more than three times the number of coronavirus tests it is currently administering over the next month.

An average of 146,000 people per day have been tested for the coronavirus nationally so far this month, according to the COVID Tracking Project, which on Friday reported 3.6 million total tests across the country. To reopen the United States by mid-May, the number of daily tests performed between now and then should be 500,000 to 700,000, according to the Harvard estimates.

That level of testing is necessary to identify the majority of people who are infected and isolate them from people who are healthy, according to the researchers. About 20 percent of those tested so far were positive for the virus, a rate that the researchers say is too high.

“If you have a very high positive rate, it means that there are probably a good number of people out there who have the disease who you haven’t tested,” said Ashish Jha, the director of the Harvard Global Health Institute. “You want to drive the positive rate down, because the fundamental element of keeping our economy open is making sure you’re identifying as many infected people as possible and isolating them.”

[BBfanboy]

Here's an unusual result of the infection - an actor loses his leg because of "Coronavirus complications".

https://www.cbc.ca/news/entertainment/n ... -1.5537671

For all those young people who think they can weather a bout of the virus and come out unscathed, that is not necessarily the outcome. Depending how severe it gets before recovery they could be looking at lung scarring, damage to other organs including the brain, and now loss of limbs. I haven't heard news stories emphasize this enough. It would be helpful to have some stats on the number of patients by age group that recover but with significant permanent damage.

[Moltrey]

Popping back in here guys. I just heard or read a couple days ago another reference to the Covid 19 virus originating in a Chinese lab rather than the wet market in Wuhan.
Any of you shed light or other stories on this?

Our lack of understanding about this virus and its apparent slipperiness are making things scary. We don't know very much about it still. Lets hope that changes asap.

[RangerJoe]

Read back and you should find something on it.

[Chickenboy]

ORIGINAL: obvert

ORIGINAL: Cap Mandrake

Chickenboy is right. There are numerous obstacles to testing. When the CDC relinquished exclusive testing in the US and the private and university labs started to step up we set up expensive tents and outdoor heaters and paid a bunch of staff to gown up in face masks, and N-95 masks to collect the specimens...and then we ran out of viral transport media...and then when, after all effort we finally got the specimens to Quest it took 6-7 days to get a result...and then we had only 10% positive after selecting for the sickest appearing patients.

And yet, more tests are what will get the country open again according to this.

https://www.nytimes.com/interactive/202 ... e=Homepage

As some governors consider easing social distancing restrictions, new estimates by researchers at Harvard University suggest that the United States cannot safely reopen unless it conducts more than three times the number of coronavirus tests it is currently administering over the next month.

An average of 146,000 people per day have been tested for the coronavirus nationally so far this month, according to the COVID Tracking Project, which on Friday reported 3.6 million total tests across the country. To reopen the United States by mid-May, the number of daily tests performed between now and then should be 500,000 to 700,000, according to the Harvard estimates.

That level of testing is necessary to identify the majority of people who are infected and isolate them from people who are healthy, according to the researchers. About 20 percent of those tested so far were positive for the virus, a rate that the researchers say is too high.

“If you have a very high positive rate, it means that there are probably a good number of people out there who have the disease who you haven’t tested,” said Ashish Jha, the director of the Harvard Global Health Institute. “You want to drive the positive rate down, because the fundamental element of keeping our economy open is making sure you’re identifying as many infected people as possible and isolating them.”

The authors are advocating additional testing that may be necessary to identify positive people that are sick and their contacts. This is reasonable, based upon the testing rubric that most states have-the 'flow chart' testing process I provided as an example. This is not a call to random test the populace to identify asymptomatics.

There are some states above 20% attack rate: New York, New Jersey, Massachusetts, Pennsylvania, Georgia, Illinois, Connecticut and Michigan. Louisiana is below that threshold of late. New York's and New Jersey's big numbers skew the national averages because of their outsized impact (~40% and nearly 50%(!) ARs respectively). The other states have known niduses of infection in cities that are well known. Governors of these states will probably have to take this into account and these states may have to remain under additional scrutiny until their attack rate drops. New York's numbers are improving and the attack rate is off by some 10% from its highs a couple weeks ago.

Some states at or near this 20% rate may need to step up their game a bit in terms of testing numbers. Georgia's tests / M looks a little meager compared to the others with an attack rate circa 20%.

But for the other big population states: California, Texas and Florida that are well below this 20% attack rate threshold, the governors should have some freedom to begin opening up the economies and getting people back to work. The granularity of this is important and I don't think the national averages have much bearing on state by state reopenings. The exceptions above (the few states >20%) may have to 'test out' of mitigation strategies. But the other 42 states can reasonably start getting things moving again.

[Chickenboy]

@ obvert/Warspite1/Encircled (or other Brits)

Have you lot found a website that provides granular detail across the UK? I'm talking county by county / country by country (including Wales too of course) for Scotland, England, Wales and N. Ireland? I don't know how to get that stuff from the Worldometers or Covid Tracking Project sites-my 'go to' sites for daily national and state information.

[Alfred]

ORIGINAL: Chickenboy


... I will be keen to follow the (hopefully) international response(s) in the coming years.

The Australian Foreign Affairs minister has called for an international inquiry, not run by WHO, into the entire COVID-19 pandemic.

https://www.abc.net.au/news/2020-04-19/ ... 9/12162968

She made the obvious observation that the inquiry would need all countries to be fully transparent. Further down the article there are some interesting hints about the Australian government's future relationship with WHO.

Already a Chinese academic from Shanghai has strongly criticised the need for an international inquiry on the basis that China has been fully transparent. He kindly reminded Australia that China's relationship with Australia would be adversely affected as we should not be following Trump's direction of misrepresenting China's role.

Personally I have zero faith that anything meaningful will result from this initiative. China will bully/bribe African/Asian leaders into not cooperating. Too many western governments (including Australia's) will be afraid of suffering any economic pain from the inevitable Chinese "punishment". Any remaining countries participating in such an inquiry will find it a pointless exercise when one bears in mind there is already a Chinese law which makes it a criminal offence for any Chinese national to provide information on COVID-19 to foreigners without prior approval. Plus the specimens taken from the early Chinese victims have already, in accordance with a government directive, been destroyed.

IN international diplomatic terms, China is just gong to walk away scott free. that can only change if western governments are prepare to pay the costs associated with having the creation of a new bamboo curtain. I'm not holding my breath on that.

Alfred

[RangerJoe]

ORIGINAL: Alfred

ORIGINAL: Chickenboy

... I will be keen to follow the (hopefully) international response(s) in the coming years.

The Australian Foreign Affairs minister has called for an international inquiry, not run by WHO, into the entire COVID-19 pandemic.

https://www.abc.net.au/news/2020-04-19/ ... 9/12162968

She made the obvious observation that the inquiry would need all countries to be fully transparent. Further down the article there are some interesting hints about the Australian government's future relationship with WHO.

Already a Chinese academic from Shanghai has strongly criticised the need for an international inquiry on the basis that China has been fully transparent. He kindly reminded Australia that China's relationship with Australia would be adversely affected as we should not be following Trump's direction of misrepresenting China's role.

Personally I have zero faith that anything meaningful will result from this initiative. China will bully/bribe African/Asian leaders into not cooperating. Too many western governments (including Australia's) will be afraid of suffering any economic pain from the inevitable Chinese "punishment". Any remaining countries participating in such an inquiry will find it a pointless exercise when one bears in mind there is already a Chinese law which makes it a criminal offence for any Chinese national to provide information on COVID-19 to foreigners without prior approval. Plus the specimens taken from the early Chinese victims have already, in accordance with a government directive, been destroyed.

IN international diplomatic terms, China is just gong to walk away scott free. that can only change if western governments are prepare to pay the costs associated with having the creation of a new bamboo curtain. I'm not holding my breath on that.

Alfred

I have already decided that, as much as is possible, I will not buy things made in China. Especially any food grown or processed there. I like my food and it most definitely shows!

[Cap Mandrake]

ORIGINAL: Alfred

ORIGINAL: Chickenboy


... I will be keen to follow the (hopefully) international response(s) in the coming years.

The Australian Foreign Affairs minister has called for an international inquiry, not run by WHO, into the entire COVID-19 pandemic.

https://www.abc.net.au/news/2020-04-19/ ... 9/12162968

She made the obvious observation that the inquiry would need all countries to be fully transparent. Further down the article there are some interesting hints about the Australian government's future relationship with WHO.

Already a Chinese academic from Shanghai has strongly criticised the need for an international inquiry on the basis that China has been fully transparent. He kindly reminded Australia that China's relationship with Australia would be adversely affected as we should not be following Trump's direction of misrepresenting China's role.

Personally I have zero faith that anything meaningful will result from this initiative. China will bully/bribe African/Asian leaders into not cooperating. Too many western governments (including Australia's) will be afraid of suffering any economic pain from the inevitable Chinese "punishment". Any remaining countries participating in such an inquiry will find it a pointless exercise when one bears in mind there is already a Chinese law which makes it a criminal offence for any Chinese national to provide information on COVID-19 to foreigners without prior approval. Plus the specimens taken from the early Chinese victims have already, in accordance with a government directive, been destroyed.

IN international diplomatic terms, China is just gong to walk away scott free. that can only change if western governments are prepare to pay the costs associated with having the creation of a new bamboo curtain. I'm not holding my breath on that.

Alfred

There will be a Congressional investigation in the US. No hope of that before November I suspect. We will almost certainly never find out if it was an accidental release from Bat Woman's lab. That would require a very high level defection of a Chicom scientist or high official with no living relatives.

US civil litigation against Chinese companies with culpability might yield results but any award would be offset by the Chicoms seizing US owned assets in China.

What we need is a major Western leader who has been droning on about unfair Chinese trade practices for 10 years. [:D] Any ideas?

[Cap Mandrake]

American consumer boycotts of Chinese products could do serious damage.

[CaptBeefheart]

Some more news from Korea: Thirteen new cases on Sunday, with seven from overseas. There have been 8,114 recoveries out of 10,674 cases. Deaths have reached 236. Here's the latest: S. Korea reports fewer than 20 virus cases for 3rd day.

I asked the missus (who works at a major hospital) about testing, and she said there won't be any additional testing beyond the usual contacts of known carriers and those showing symptoms (and airport entries). In other words, testing will be quite minimal from here on out (barring a big spike, of course). Everyone who needs a test can get one, with results in less than six hours, but it doesn't sound like there will be any mass testing for research purposes. In terms of tests per million population, the country's ranking will continue to decline.

My daughter will start pre-school tomorrow, with official cover from the government to open (the school board was afraid to open without some sort of CYA in place, although it would have been legal). The rumor is public schools will re-open on May 6. The churches that voluntarily shut down may be back in action this Sunday, with certain guidelines in place.

Although the economy has undoubtedly taken a hit, they're saying growth might be 0.1% this year. We shall see. It definitely looks like everything is back to normal in the business districts, but that's just on the surface, of course.

Good luck.

Cheers,
CB