How much, and on what margins, should we be rethinking quarantine protocols?

post by jmh · 2022-01-05T20:29:58.945Z · LW · GW · 1 comment

This is a question post.

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This not a researched or even all that thought out question. Perhaps it's a long rambling collection of thoughts tossed into some basket, shaken a bit and then labelled as question.

Zvi's Omicrom 12 post [LW · GW] regarding the impact of infections on overall economic activity has me thinking perhaps the CDC has not gone far enough.

Why is that not just some crazy talk? Well, I'm not sold on it not being that but am trying to consider this from a cost-benefit view.

  1. More and more evidence is coming in saying Omicron is more mild, even if more infectious.
  2. I think it's been well established that masks actually work pretty good for keeping those infected from spreading the virus to others. 
  3. Revolutions start when people are hungry or afraid -- or just generally annoyed by things repeatedly over a long enough time frame -- or it seems like that. 
  4. If we do see a lot of activity shutdown (and I've seen a few days where shelves have been pretty empty (dairy, produce) where I live. When I asked about the lack of milk one of the stockers in the store said the truck didn't arrive the prior night. (Could have been weather related but the other observations can not be attributed to weather.)
  5. The government solution is pretty much tapped out at this point I think. Further "taking up aggregate demand shortages" is not in the budget, will just further fuel inflation pressures and does nothing to increase production.

So seems like there might be a bit of weight on the cost side here. 

What about the benefit side?

We don't really seem to be slowing the spread down unless someone wants to follow the China plan. I don't think that works. For the most part we're also (not only but in numbers terms) largely benefiting by preventing the spread of low key sickness.

If we didn't really have a quarantine policy but do have a mask mandate (5 days? 10 Days?) for those testing positive that seems to put us more in the "normal" world where people who are sick are expected to avoid spreading their illness (and are generally encouraged to do so by coworkers and management) but with the benefits:

  1. masks protections for others, and
  2. a much better story line about the mask mandate -- when you're sick for a limited time (which seems to shift the discussion from mandating what risks people can assume to what risks they can impose).
  3. Potentially could actually lead to more people actually using them when they have some other shareable illness (colds, flu) where they will still go to work but now comfortable with the idea that a mask is a very nice courtesy to one's coworkers leading to less minor illnesses at work or other places with close, closed in social interactions. Now, at least for some, mask I think still have either a stigma or perhaps just a lack of familiarity for most in the USA. This isn't the case for many places on the planet.

This would also largely be about those asymptomatic cases and those with very mild cases. Not sure, but that seems to imply they are not really shedding large numbers of virus to begin with. Those with serious and severe cases are already self quarantining or in the hospital getting quarantined.

Now, a clear "but what about . . .?" is the unvaccinated and over whelming medical services.  What I'm a bit unclear on here is just how Omicron stands versus the earlier variants in the context of unvaccinated. Listen to the news and clearly the unvaccinated are at more risk than the vaccinated. But that doesn't really tell me anything about the distribution of level of sickness across the unvaccinated population. A quick Google search doesn't find anything obviously useful on that question. 

Also, if the premise that masks (and particularly better, well fit masks) are nearly as good as quarantining asymptomatic/very mild cases then that would help keep some medical staff on the job -- which keeps medical infrastructure at a higher capacity than the quarantine does. That seems like it would be good.

Clearly we (the world) is going to be living with SARS-CoV-2 for the foreseeable future and need a functional way of living with it. So what should a functional living with the virus actually look like and is the current "quarantine culture" (yes, I am being provocative here) the right one?

Answers

answer by Florin · 2022-01-14T21:58:00.032Z · LW(p) · GW(p)

Anyone that wants effective protection should wear a respirator, preferably the elastomeric kind.

While cloth and surgical masks might be okay for preventing the common cold or the flu (assuming no change in contagiousness), they don't seem to work that well for covid, and any mask that has earloops is unlikely to provide an adequate seal, regardless of its theoretical filtration capability. Evidence: these sorts of masks seemed to have helped wipe out the flu and common cold but not covid in the winter of 2020/2021 and didn't seem to have made much of a dent in the subsequent covid waves of 2021.

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comment by jmh · 2022-01-07T03:32:03.652Z · LW(p) · GW(p)

Small update. Seems that one of the local medical organizations has come to some conclusion on the question as well.

Coronavirus-positive but asymptomatic nurses who have received a vaccine and booster are directed to return to work immediately with no period of isolation, according to Inova guidelines dated Dec. 28. Periods of isolation vary based on vaccination status and range from five days for mild symptoms to up to 20 days or longer for those with severe illness. (https://www.washingtonpost.com/dc-md-va/2022/01/05/omicron-wave-dc-hospitals-death/)