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Guest opinion: Why is COVID-19 spreading so rampantly? Here are three factors to consider.

Maddie Ta, 17, receives a nasal swab test from one of the traveling nurses staffing the COVID-19 testing site at the lobby of Palo Alto City Hall on June 16. Photo by Lloyd Lee.

Why is the virus spreading here at its current higher level now? I don't know exactly, but it appears to me that there are three major factors.

In order to understand what's going on completely with transmission risks, we would need to do case-control studies. We don't have the resources to do case-control studies given the enormous burden on all the staff at the health department at this time, but we can take some educated guesses based on patterns that we are seeing here.

•The virus appears remarkably, even surprisingly, transmissible. At pretty much every point over the last six-plus months, I've been surprised, and impressed, at how capable this virus is at moving itself between people. It spreads in households like wildfire and it spreads in other indoor environments too. It seems to be everywhere we look.

I know this is hard — we're all exhausted and frustrated by having to take precautions — but the implication of this fact is that you can't let your guard down, or be careless, even once, especially if you are at high risk.

•Fundamental structural failures of the U.S. economy are being laid bare by the pandemic. These structural issues seem to be a major cause of the transmission we're now seeing, at least in San Mateo County. Many elements of the U.S. economy can be viewed as illogical, even immoral in my opinion, in that so many people are forced to live lives of economic desperation, live paycheck to paycheck, are not paid a living wage, (and) live with no workplace safety nets, like health care, paid sick leave or other wage-protection programs. While these structural issues are illogical in good times, they are downright inexplicable in times of a pandemic. These structural problems are at such a massive scale, they can not be ignored.

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A majority of people we are seeing infected now are frontline workers (people who allow the rest of us to eat, and have electricity, and have our garbage picked up, etc.) living in crowded multigenerational conditions, living with lack of trust in, and in fact have downright fear of, the government. Remember that to stem the spread of this very transmissible virus, people who are infected need to be separated from others (isolation and quarantine), not go out in public, and not go to work while they are infectious. Try getting compliance with isolation and quarantine when the infected person is the breadwinner for the family and the family will be out on the street if they don't go to work. And when they go to work they will, perhaps, interact at that job with you. There is not enough enforcement capacity in the world to stop this from happening.

"Your seemingly innocuous get-togethers are driving the spread and are a major reason why you can't go to a restaurant, why you can't go to the gym, why you can't go get your hair cut, why kids can't go to school."

-Dr. Scott Morrow, San Mateo County health officer

The implication of this is that the current business-focused restrictions will do little to stem the spread of the virus when the spread is exacerbated by these conditions. This requires rapid policy and systems changes at every level of both public and private sectors, from the feds on down, and from the largest corporations to the smallest business. We need to see much more work in this area, and we need to have less reliance on business sector closures and restrictions, beyond getting businesses to do the basic transmission control measures. Failure to fix some of these issues will prolong our collective pain.

•Complacency is the other majority factor enabling spread. This is either born of belief systems (this is all a hoax, this isn't that bad for me, let's go to a party and get infected), or born of just not paying attention. Many, many of our infections are related to fairly small gatherings of family and friends: birthday parties, picnics, eating at restaurants with mixed households, etc., without the basic precautions being taken. Most of these gatherings are innocent, no doubt, not intending to spread the virus, but they do spread it, and with far reaching implications. Please note, your seemingly innocuous get-togethers are driving the spread and are a major reason why you can't go to a restaurant, why you can't go to the gym, why you can't go get your hair cut, why kids can't go to school. Until, or unless more people get this fact, we will continue to be stuck in the situation we are in. To get out of this situation depends on all of us. Our collective best course of action: No gatherings outside of immediate households, use facial coverings extensively, and social distancing.

Dr. Scott Morrow is the San Mateo County health officer.

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Guest opinion: Why is COVID-19 spreading so rampantly? Here are three factors to consider.

by / Contributor

Uploaded: Sat, Jul 25, 2020, 8:30 am

Why is the virus spreading here at its current higher level now? I don't know exactly, but it appears to me that there are three major factors.

In order to understand what's going on completely with transmission risks, we would need to do case-control studies. We don't have the resources to do case-control studies given the enormous burden on all the staff at the health department at this time, but we can take some educated guesses based on patterns that we are seeing here.

•The virus appears remarkably, even surprisingly, transmissible. At pretty much every point over the last six-plus months, I've been surprised, and impressed, at how capable this virus is at moving itself between people. It spreads in households like wildfire and it spreads in other indoor environments too. It seems to be everywhere we look.

I know this is hard — we're all exhausted and frustrated by having to take precautions — but the implication of this fact is that you can't let your guard down, or be careless, even once, especially if you are at high risk.

•Fundamental structural failures of the U.S. economy are being laid bare by the pandemic. These structural issues seem to be a major cause of the transmission we're now seeing, at least in San Mateo County. Many elements of the U.S. economy can be viewed as illogical, even immoral in my opinion, in that so many people are forced to live lives of economic desperation, live paycheck to paycheck, are not paid a living wage, (and) live with no workplace safety nets, like health care, paid sick leave or other wage-protection programs. While these structural issues are illogical in good times, they are downright inexplicable in times of a pandemic. These structural problems are at such a massive scale, they can not be ignored.

A majority of people we are seeing infected now are frontline workers (people who allow the rest of us to eat, and have electricity, and have our garbage picked up, etc.) living in crowded multigenerational conditions, living with lack of trust in, and in fact have downright fear of, the government. Remember that to stem the spread of this very transmissible virus, people who are infected need to be separated from others (isolation and quarantine), not go out in public, and not go to work while they are infectious. Try getting compliance with isolation and quarantine when the infected person is the breadwinner for the family and the family will be out on the street if they don't go to work. And when they go to work they will, perhaps, interact at that job with you. There is not enough enforcement capacity in the world to stop this from happening.

The implication of this is that the current business-focused restrictions will do little to stem the spread of the virus when the spread is exacerbated by these conditions. This requires rapid policy and systems changes at every level of both public and private sectors, from the feds on down, and from the largest corporations to the smallest business. We need to see much more work in this area, and we need to have less reliance on business sector closures and restrictions, beyond getting businesses to do the basic transmission control measures. Failure to fix some of these issues will prolong our collective pain.

•Complacency is the other majority factor enabling spread. This is either born of belief systems (this is all a hoax, this isn't that bad for me, let's go to a party and get infected), or born of just not paying attention. Many, many of our infections are related to fairly small gatherings of family and friends: birthday parties, picnics, eating at restaurants with mixed households, etc., without the basic precautions being taken. Most of these gatherings are innocent, no doubt, not intending to spread the virus, but they do spread it, and with far reaching implications. Please note, your seemingly innocuous get-togethers are driving the spread and are a major reason why you can't go to a restaurant, why you can't go to the gym, why you can't go get your hair cut, why kids can't go to school. Until, or unless more people get this fact, we will continue to be stuck in the situation we are in. To get out of this situation depends on all of us. Our collective best course of action: No gatherings outside of immediate households, use facial coverings extensively, and social distancing.

Dr. Scott Morrow is the San Mateo County health officer.

Comments

Mark
another community
on Jul 25, 2020 at 10:30 pm
Mark, another community
on Jul 25, 2020 at 10:30 pm
18 people like this

You forgot to mention that while gathering are legally limited to 10 people, in the 7 weeks since the murder of George Floyd tens of millions of people have gathered in groups of thousands to protest, and sometimes to riot. The current spike in cases began 2 weeks later and increased from there. Either that was a major cause of the explosion of cases, or the virus is smart enough to infect people with some political views while leaving those with other political views alone.


Menlo Voter.
Menlo Park: other
on Jul 26, 2020 at 9:31 am
Menlo Voter., Menlo Park: other
on Jul 26, 2020 at 9:31 am
16 people like this

Mark:

it also coincided with the opening of public spaces in which stupid people didn't follow proper protocols. And far more people than protesters were doing that. Just google it. There's plenty of photographic evidence to support it. Of course, it doesn't go along with your narrative, so I doubt you will.


Peter Carpenter
Menlo Park: Park Forest
on Jul 26, 2020 at 10:04 am
Peter Carpenter, Menlo Park: Park Forest
on Jul 26, 2020 at 10:04 am
24 people like this

1 - Lack of Personal Responsibility
Many people are still not wearing masks and/or remaining a SAFE distance from others,

2 - Lack of Leadership
When was the last time you heard any local official (except Anna Eshoo!) speak out, speak loudly and speak clearly about what we all have to do to stop this virus?

3 - Lack of Strong, Clear, Consistent Messaging
Where are the TV ads, newspaper ads, banners and signs exhorting all of us to do what we need to do to stop this killer?

4 - Lack of Testing and Contact Tracing
California has the second largest number of cases in the US and ranks 14th in the rate of testing.

In many ways this virus is an IQ/EQ/economic status test and Darwin will prevail.


Blame?
another community
on Jul 26, 2020 at 11:42 am
Blame?, another community
on Jul 26, 2020 at 11:42 am
13 people like this

Obviously, mass gatherings for riot/protest increased the spread of corona virus. It's not "politically correct" to point this out, but, again, this is obvious. Mark is correct.

“It’s a perfect setup for further spread of the virus,” said Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases in the United States, in early June. “I get very concerned, as do my colleagues in public health, when they see these kinds of crowds. There certainly is a risk. I can say that with confidence.”

Menlo Voter is also correct. Reopening without proper precautions would also lead to increased spread. However, the few times I've been out and about in the Bay Area, I've seen almost everyone wearing a mask.

Which contributed more? We will never know.


gps
Las Lomitas School
on Jul 26, 2020 at 1:27 pm
gps, Las Lomitas School
on Jul 26, 2020 at 1:27 pm
7 people like this

Web Link
Web Link
Web Link

There isn't data to suggest that protests caused a meaningful change in spread. Far far more people were busy spreading it in other ways. Realize that most people were never at protests or with people who were at protests. Even though we wanted to be. Because of the pandemic. Nobody can honestly blame protests on the wide spread we're seeing.

The so called "Mark" and "Blame?" commenting above are behaving like racist trolls abusing this quasi-anonymous forum to further inequity. They clearly haven't internalized Dr. Morrow's words about structural inequality.


new guy
Menlo Park: Downtown
on Jul 26, 2020 at 1:37 pm
new guy, Menlo Park: Downtown
on Jul 26, 2020 at 1:37 pm
7 people like this

Sorry, there is no logic that can inform me that the riots/protests did not spread the virus, and then cause further spread be those infected going back to their neighborhoods. If it is so Scientifically proven that you are correct (protests) did not impact the "case" numbers, then why do we (government/scientists/etc.) not have any other thing proven about this virus, like at all. So mass outdoor gatherings are "safe"?


Peter Carpenter
Menlo Park: Park Forest
on Jul 26, 2020 at 1:49 pm
Peter Carpenter, Menlo Park: Park Forest
on Jul 26, 2020 at 1:49 pm
25 people like this

Quit arguing about angels on the head of a pin.

The FACTS are that the virus is continuing to spread in San Mateo (R = 1.12)and Santa Clara (R = 1.15) counties in the absence of mass gatherings:

Web Link


Going out in public without a mask is now the moral equivalent of drunk driving.




PV Res
Portola Valley: Central Portola Valley
on Jul 26, 2020 at 4:54 pm
PV Res, Portola Valley: Central Portola Valley
on Jul 26, 2020 at 4:54 pm
7 people like this

My body, my choice. I shouldn’t have to wear a mask if I don’t want to. And I have allergies, so l do not have to because it is a valid medical condition. I get kicked out of stores in menlo for it but I stand for what I believe is right and shop with my feet. Tired of people telling me what to do—stay in your own lane. If you are afraid of the virus then you shouldn’t be out in public in the first place.


Menlo Voter.
Menlo Park: other
on Jul 26, 2020 at 7:06 pm
Menlo Voter., Menlo Park: other
on Jul 26, 2020 at 7:06 pm
5 people like this

Peter:

PVres is our resident troll. Ignore her.


John Muir
Atherton: West Atherton
on Jul 27, 2020 at 9:21 am
John Muir, Atherton: West Atherton
on Jul 27, 2020 at 9:21 am
6 people like this

Dr. Morrow:

Some good points, but also a lot drivel.

I wish you would run for public office so that I could vote against you.


Liesel
Portola Valley: Central Portola Valley
on Jul 27, 2020 at 10:29 am
Liesel, Portola Valley: Central Portola Valley
on Jul 27, 2020 at 10:29 am
15 people like this

The virus doesn't know why groups of folks are gathered and it doesn't play politics. Groups of individuals, large or small, protesting, shopping, or going to sporting events are excellent vectors to spread the virus. Given the evidence from other countries, wearing a mask helps slow down transmission, and deaths.


Longtime Menlo Parker
Menlo Park: Menlo Oaks
on Jul 27, 2020 at 12:48 pm
Longtime Menlo Parker, Menlo Park: Menlo Oaks
on Jul 27, 2020 at 12:48 pm
3 people like this

Sadly, too many folks are still gathering in public and not wearing masks. Case in point: I drove on Skyline yesterday afternoon (near Alice's) and there was an informal car show/gathering on the side of the road (Mustangs, I believe) with everyone milling about admiring each other's car and taking pictures. Probably 40+ people, with NO masks :-(


Observer
Menlo Park: other
on Jul 27, 2020 at 12:58 pm
Observer, Menlo Park: other
on Jul 27, 2020 at 12:58 pm
8 people like this

Since the medical community endorsed the protests from the get go (Web Link), it is not surprising that they are bending over backwards to provide “research” to say the protests are not the cause of the increase. The research I have read strains credulity. (Eg Bentley study that during protests, others stayed home to offset the number of people out— like a game of carbon offsets.). At a minimum, it seems logical that endorsing the protests set an example for other interactions and a lowering of people’s guard. You can’t tell young people not to gather to make signs after telling them they can attend a protest. The medical community should never have said some mass gathering were good... that political stand let the cow out of the barn.

One hope is that we reach herd immunity as it seems has happened in New York, New Jersey, etc.



stan
Portola Valley: Los Trancos Woods/Vista Verde
on Jul 27, 2020 at 1:42 pm
stan, Portola Valley: Los Trancos Woods/Vista Verde
on Jul 27, 2020 at 1:42 pm
9 people like this

It would certainly be politically incorrect to assert that many thousands of people gathering with and without masks, shoulder to shoulder, shouting and screaming and spitting somehow were able to convert mob behavior into herd immunity.
This really bodes well if this miracle of immunity can be repeated for football and baseball games in outdoor arenas as at least these will translate to some form of positive commerce as compared to rioting mobs that create commerce through having to replace broken windows and clean graffiti from streets and buildings.


Come from the place of your heart.
Menlo Park: Fair Oaks
on Jul 27, 2020 at 2:35 pm
Come from the place of your heart., Menlo Park: Fair Oaks
on Jul 27, 2020 at 2:35 pm
19 people like this

We can't blame it on only one thing, so to get caught in that argument is silly because we need to move forward and find a way to be healthy and together in this time. What we do know medically is that not wearing masks when in close proximity to other people, and especially gathering in groups that aren't socially distanced, is the most irresponsible thing we can do. It's proven on both sides of the political spectrum that not wearing a mask spreads the virus. So can we please drop politics and treat this like what it is -- an illness that affects us all?
To move forward safely, we need to look at our own actions and choices.
I was just over on the coast in Half Moon Bay this morning and there were multiple surf schools with very full classes of young kids through later teens. Everyone was on the beach for various warm-ups and initial lessons. Literally none of the kids had masks on and none of them were more than a couple feet apart. There were hoards of kids (a technical term for lots and lots). I know kids are less likely to get it, but they are very likely to spread it. Living on this side of the hill, I also know first hand (I'm a mom of a person on instagram) that a lot of the local older youth are gathering unmasked and unsocially distant and with regularity.
So, it's a choice. We can manage ourselves and manage our kids and all do our best. Or we can watch the numbers go up and people dying, often because of our own actions, and keep complaining and wanting things to be the way they were and pretending that they are.
The people in service jobs are dying because we aren't wearing masks.
So, as I can see it, here's my choice: me wearing my mask protects you, and so I'll do that for you. You wearing your mask protects me; I hope you'll do that for me.
let's stop fighting and try to keep each other healthy and alive so we can find creative ways to have fun and learn and work.


Sara T
Menlo Park: other
on Jul 27, 2020 at 2:57 pm
Sara T, Menlo Park: other
on Jul 27, 2020 at 2:57 pm
5 people like this

I heartily endorse the comments of "Come from the place of your heart." The ONLY important thing is to wear a mask and stay at least 6 feet apart. The news of the kids at Half Moon Bay is extremely upsetting. Parents MUST be responsible for their children's actions.


Peter Carpenter
Menlo Park: Park Forest
on Jul 27, 2020 at 2:58 pm
Peter Carpenter, Menlo Park: Park Forest
on Jul 27, 2020 at 2:58 pm
8 people like this

"One hope is that we reach herd immunity as it seems has happened in New York, New Jersey, etc."

Herd immunity has NOT been reached anywhere in the US and probably nowhere in the world.

What has happened in New York and New Jersey is that so many people died there that most people knew someone who had died and and that reality changed their behavior.

Hopefully we won't need to learn the same lesson here the hard way.


Dr Marina Kalugina (also Kalugin)
Menlo Park: other
on Jul 27, 2020 at 3:01 pm
Dr Marina Kalugina (also Kalugin), Menlo Park: other
on Jul 27, 2020 at 3:01 pm
Like this comment

[Post removed due to trolling]


another resident
Menlo Park: The Willows
on Jul 27, 2020 at 3:36 pm
another resident , Menlo Park: The Willows
on Jul 27, 2020 at 3:36 pm
8 people like this

I find depressing many of the comments on this thread, and I hope they represent the views of a minority of our community. This is a time for our community to work together to really slow the spread of this virus, so that we can get our kids back to school and workers back to work. This isn't a question of individual risk tolerance. We are wearing masks for each other, for the essential workers who cannot socially distance in their jobs, for our kids who need to go to school (and the teachers who need to be safe teaching them), for the elderly and immunocompromised. Every single one of us is either in one of these groups or closely linked to someone in one of these groups.

I agree with Peter Carpenter that we need stronger and clearer messaging from our government officials. I appreciate this thoughtful piece by Scott Morrow, but it will reach very few. I have educated and responsible friends who are not following the rules -- and they don't know they're not following the rules because the rules are so unclear and differ from county to county. In San Mateo County we're allowed to have social bubbles, but in San Francisco they can have up to 2 outdoor social meals per week. It's too confusing to understand, and there's very little effort to publicize the compliance requirements. We should have a strong marketing campaign with billboards, television, online and radio adds, etc. And these adds should be very clear.

We also should require businesses that are open to post common requirements for patrons with clearly visible -- and friendly, charming, or even funny! -- signs that remind patrons of the common rules. e.g., outdoor restaurants could have signs reminding patrons that they're open only for members of the same household or clearly defined social pods.


Peter Carpenter
Menlo Park: Park Forest
on Jul 29, 2020 at 2:35 pm
Peter Carpenter, Menlo Park: Park Forest
on Jul 29, 2020 at 2:35 pm
5 people like this

From: Peter Carpenter
Subject: Our silent local elected officials - PLEASE require everyone to wear a mask in any public space
Date: July 29, 2020 at 2:18:49 PM PDT

We will never contain this virus without universal masking.

No masks = No economic recovery
No masks = More deaths

Peter

Web Link


Peter Carpenter
Menlo Park: Park Forest
on Aug 1, 2020 at 8:24 pm
Peter Carpenter, Menlo Park: Park Forest
on Aug 1, 2020 at 8:24 pm
4 people like this

We should recognize that San Mateo County is having to backup because of people who are not wearing masks and who are not social distancing.

The very people who demanded more "freedom" are the ones responsible for us having less freedom.

Actions and inactions have consequences.


Peter Carpenter
Menlo Park: Park Forest
on Aug 2, 2020 at 7:46 am
Peter Carpenter, Menlo Park: Park Forest
on Aug 2, 2020 at 7:46 am
3 people like this

"The coronavirus is spreading at dangerous levels across much of the United States, and public health experts are demanding a dramatic reset in the national response, one that recognizes that the crisis is intensifying and that current piecemeal strategies aren’t working."


Web Link


Menlo Voter.
Menlo Park: other
on Aug 2, 2020 at 9:12 am
Menlo Voter., Menlo Park: other
on Aug 2, 2020 at 9:12 am
4 people like this

We need a national strategy, but we'll never see one from captain heal spur. As long as it was killing people in blue states he was fine with it. Now that it's killing his base he's not sure what to do. Wear a mask don't wear mask? He doesn't know.


Peter Carpenter
Registered user
Menlo Park: Park Forest
on Aug 10, 2020 at 10:24 am
Peter Carpenter, Menlo Park: Park Forest
Registered user
on Aug 10, 2020 at 10:24 am
3 people like this

We need a nationwide lockdown that is opened up only when we can test everyone and trace every positive case.

Expensive - yes.

Painful - very.

The alternative - probably over 10 million infected and 300,000 deaths AND a ruined economy.

"To save lives, and save the economy, we need another lockdown."

By Michael T. Osterholm and Neel Kashkari
Dr. Osterholm is director of the Center for Infectious Disease Research and Policy at the University of Minnesota. Mr. Kashkari is president of the Federal Reserve Bank of Minneapolis.

Web Link


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