It would be good to hear plausible scenarios of how people still catch it despite of masks and social distancing. There is something to learn from each story. And I see a distinct lack of focus on anecdotal stories of how people think they caught it. How the fuck are people catching this disease?
The other thing I got from the article is that South Korea is on a whole different level of testing than the US. When infection was detected, they tested everyone who was in the building or had visited: 1143 people tested with results in 12-24 hours. Everyone positive was isolated and everyone negative was quarantined and re-tested for 14 days. They also texted 16,628 people who had been near the building for more than 5 minutes (from cell data), telling them to avoid contact with others and get tested. This level of testing and tracing got South Korea (51 million people) to the point that it is now averaging just 10 new cases per day.
[1] https://wwwnc.cdc.gov/eid/article/26/8/20-1274_article [2] https://wwwnc.cdc.gov/eid/article/26/8/20-1274-f2
According to [1] and [2], the US has performed twice as many tests per capita as South Korea. Roughly:
The US has performed 8.9 million tests for a population of 330 million (27 tests per thousand people).
South Korea has performed 660 thousand tests for a population of 50 million (13 tests per thousand people).
1: https://www.realclearpolitics.com/coronavirus/
2: https://ourworldindata.org/coronavirus-testing#how-many-tota...
That's probably because South Korea managed to quickly contain the spread by starting large-scale testing much much earlier. And its number of new daily cases of COVID-19 reached the peak on February 29.
Japan's government didn't respond quickly to COVID-19 (some have even said they actively tried to downplay it to protect the Olympics) and yet Japan has very few cases.
Perhaps the difference is cultural, or geographic, or travel patterns, or something else entirely.
2. Many people are still working in industries where they aren’t social distancing, e.g. all the meat packing plant outbreaks where sick employees were ordered to continue working in close proximity to their coworkers and nearly every employee in the plant got infected.
3. Positive cases are being sent home to quarantine in the same residence as their uninfected family members, who then catch the virus. Some other countries are either quarantining sick cases in the hospital, in hotels, or in monitored quarantine sites, but we haven’t been doing that in most cases and so we send home a positive case and they then infect everyone else in their home. This is worst in nursing homes but is happening in multigenerational households and other households as well. https://www.nydailynews.com/coronavirus/ny-coronavirus-cuomo...
One of the issues is that not everyone is wearing masks or properly social distancing. If you have any opportunity to go out and safely observe from a distance any groups, you'll notice a sizable fraction not wearing masks and many not properly distancing themselves.
All it takes is some percentage of those who are not mask wearing or distancing also being asymptomatic spreaders to keep the spread going.
If wearing a mask keeps you from spreading it, the question is how did you get it?
With the reasoning you are giving, a single case of this will have to spread to lethal numbers quickly. But the more we learn, the more it seems it was here for a while before it broke into long term care facilities and deaths started spiking.
So, again, what is the actual vector here. How are folks getting it?
I confess I believe the general idea. But it has been pushed with a ton of heavy handed bs from folks saying how much they protect you. And then completely neglect to account for the scores of folks in masks that are still getting it. How?
I'm ok with "we don't fully know." To that end, take my question to be as much "how could we figure out how folks are actually getting it?"
As things stand, I'm mainly seeing ridiculous reaches by folks to sanitize all things into their houses, with no logic to why they is what they should do. Feels more like managers that want you busy, without focusing on what you are busy doing.
Yah, people - that's why Gwyneth Paltrow is rich
Here's some facts, seems to be the best summary I can find - https://www.health.qld.gov.au/news-events/news/novel-coronav...
edit: here's another one https://www.abc.net.au/news/health/2020-03-28/is-coronavirus...
Many people don't realise how much contact spread can occur in just half an hour as well, as seen [0]. This was modelling the spread inside of a dining hall of a cruise ship, but you can imagine similar behaviour in other public spaces.
https://www.airforcemag.com/goldfein-time-to-dust-off-the-mo...
I got to toilette hypothesis, so don't know if the rest had data. That said, this still sounded like speculation. Are the rest more backed with data?
Surfaces play a significant but minor role, outside exposure (a lot of air) is almost irrelevant as long as people don't stay long close to each other.
This is one https://wwwnc.cdc.gov/eid/article/26/7/20-0764_article Image https://i.insider.com/5ea01ef938bf2357b9756173?width=750&for...
As we are two months into this, we really should be getting regular updates on infection events.
One of the difficulties in disease modeling is how very many transmission vectors that aren't accounted for.
Further, the virus can take 5-14 days to show symptoms, and people don’t go for a test immediately. So confirmed cases lag actual infections.
Many countries that have lifted their lockdowns and are now requiring masks in the post-lockdown stage, require those masks to be worn only on public transportation or in shops. Overall, public-health authorities do not believe that people pulling down their mask in the open air to eat or talk on their phone, will significantly change the infection curve for the worst.
Let us remember that the public-health goal here is not to prohibit any and all behavior that could potentially, under very ideal circumstances, result in transmission. Rather, the goal is to institute a few general rules that will flatten the curve to the point where contact tracing is effective. People should heed their local authorities on what to do, but I am troubled by the moral panic where posters such the above are insisting on even more stringent behavior than required by the public-health authorities.
With regard to hand-washing, touching things is now seen as so relatively unlikely a form of transmission, that some countries which initially required supermarkets to provide gloves and hand sanitizer, have decided to lift that requirement (while keeping the mask requirement). Of course hand washing in general is a good thing, but authorities in many countries do not think that obsessively doing so will make a real impact on COVID-19 transmission rates across society.
My public health authority does say you must wash hands before putting on, before taking off, and after taking off a non-medical face mask.
We can only expect the general public to observe any restrictions to the least possible degree; only if there is a hard rule that is being enforced will society overall heed it. Public-health authorities generally know this, and so if they are not pushing for certain behavior to be actively enforced, then that behavior likely matters less to curve-flattening efforts than you might assume.
I wasn't really complaining, I was positing a mechanism for the OP's question of "How are people catching COVID-19 [despite masks and social distancing]?"
No. "Public health authorities" are all really clear: if you're going to wear PPE you need to do it properly. DIY cloth masks are not PPE, they're theatre, so it doesn't really matter whether you wear it or not.
> With regard to hand-washing, touching things is now seen as so relatively unlikely a form of transmission
This is untrue. Some people on HN are fixated on droplets and aerosols, but we know that fomites are a significant risk.
https://www.nejm.org/doi/full/10.1056/NEJMra032498
> The primary mode of transmission appears to be through direct or indirect contact of mucous membrane (eyes, nose, or mouth) with infectious respiratory droplets or fomites.3,26,27 The use of aerosol-generating procedures (such as endotracheal intubation, bronchoscopy, and treatment with aerosolized medication) in hospitals may amplify the transmission of SARS-CoV, and outbreaks have involved more than 100 patients on occasion.3,26-28 SARS-CoV survives for many days when dried on surfaces and in feces at an alkaline pH.33 Although data from direct comparisons are not yet available, a review of previously published data suggests that SARS-CoV may be far more stable than other human respiratory viruses, such as respiratory syncytial virus. The role of fecal–oral transmission is unknown but may be important, given that profuse watery diarrhea is a common feature of the disease and that SARS-CoV is shed in large quantities in stool.
You are confusing two things here. For preventing certain people in certain contexts from being infected, PPE is important. For preventing the average person walking around from infecting others to the point of upsetting curve-flattening efforts, any kind of face covering (even if it be a scarf or a Buff) will satisfy the requirement in most countries now.
Indeed, the public health authorities – at least in Europe which is presently my main concern – are very clear here: the authorities overall are calling for masks to be required only in shops or on public transportation. Countries like Poland and the Czech Republic which require masks to be worn at all times in public are outliers. (And I expect their rules to soon be harmonized with the less strict countries. De facto in Poland the outdoor requirement is not even being strictly enforced outside the major cities).
Even the CDC is now promoting cloth masks:
https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-si...
Which isn't to say you shouldn't wash your hands, because there are other things you get on your hand which can make you ill. It means keep the damn mask on, and don't take it off until you're well out of range of other people.
If that turns out to be misinformation it could be extremely dangerous advice.
b) not everyone is socially distancing to the same degree.