Safety Protocols for Getting Back to Work

China bent the curve, Italy bent the curve and I believe that the curve is bending in the United States. Suppression is working and the second part of the strategy of test, trace and isolate will start to come into play in a few weeks. The states are gearing up to test, trace and isolate and several large serological surveys are already underway which will gives us a much better idea of how widely the virus has spread. Ideally, we will move from test, trace and isolate to a situation where we can conduct millions of tests weekly which will take us into the vaccine time.

Before testing is fully operational, however, we will need to follow safety protocols. We can learn about what works from what essential workers are doing now. Green Circuits in CA, for example, redesigned the shift schedule:

His first move was to redesign the plant’s work schedule. The company, owned by the Dallas-based private equity firm Evolve Capital, always had the first and second shifts overlap for a half-hour. That allowed workers arriving in the afternoon to confer with colleagues as they handed off duties.

But O’Neil said they realized that would risk their whole workforce getting quarantined for 14 days, if someone got infected by the coronavirus and spent time at the factory as part of this larger group.

The solution was to create three separate teams of 40 workers each. The first shift now ends at 2 p.m., and then there’s an hour when the workspaces, tools, and breakrooms are sanitized. The third team does not work at all, but rather is held in reserve and available to jump in if an illness hampers one of the two other teams of workers.

Other safety protocols include:

  • Shift work for white collar workers as well as for blue collar workers. Including spreading work over the weekends.
  • Senior shopping hours.
  • Temperature checks, perhaps via passive fever cameras at work and public transport.
  • Mandatory masks for public transportation.
  • Masks for workers.
  • Sanitation breaks for mandatory hand washing.
  • Quarantining at work for essential workers, as the MLB is thinking of doing despite not being essential.
  • Reducing touch surfaces (even with simple things like propping up bathroom doors) and copper tape for hi-touch surfaces that cannot be eliminated.

It will take longer to reopen restaurants, clubs and sports stadiums but I believe that applying these protocols will allow many of us to work safely. We aren’t ready yet but now is the time to plan for our return.

Comments

Along very similar lines, I wrote in Taki's Magazine about how recreational activities could be reorganized to minimize the chance of infection:

https://www.takimag.com/article/post-lockdown-hacks/

It's an remarkable post for all the web users; they will get benefit from
it I am sure.

The Germans looked in their worst area and found that the transmission was not due to touching surfaces. The mortality rate may be similar to the flu, which also is mostly dangerous to the immune compromised and old. We have a responsibility to be rational.

You must be new here.

I wonder how well the senior shopping hours are working. I say that because I have heard seniors grumble about how crowded the grocery stores are during senior shopping hours. And yet, when I've gone a little later in the morning (9am) there is virtually no one there.

The seniors have to show up early for everything, even though they have plenty of time.

Shifts/teams may reduce the risk, but what if one member of a shift/team gets Covid-19, should all of the other members of that shift/team be quarantined? Of course, getting back to work also means getting back to one's social life, and the risk that entails. That this is going to be a challenge should not excuse taking steps to reduce the risk, but ramping back up only to shut back down is a costly endeavor. My point is that ramping back up from a lockdown is a lot harder than the lockdown.

At McDonald's they just walk out and clamor for protective gear. Asking for hazard pay wouldn't be out of the question. Do they even get healthcare?

https://fox5sandiego.com/news/local-news/mcdonalds-employees-stage-walkout-after-learning-coworker-tested-positive-for-coronavirus/

"Shifts/teams may reduce the risk, but what if one member of a shift/team gets Covid-19, should all of the other members of that shift/team be quarantined?"

For a restaurant, yes that might make sense. For a factory, it would be absurd. You'd probably just need to tackle it as a standard contact trace.

If you have a third shift you are paying to wait in the wings, yes, you send your first shift home and bring in the third shift.

People say "two weeks to make sure" but that's overkill. Most people show symptoms in a few days. And testing is going to become more practical and available as time goes by.

My suggestions.

(i) Early release for people who work outdoors.
(ii) Early release for those aged 20 - 30.

Subject to risks for any vulnerable people they live with e.g. grandma.

'and I believe that the curve is bending in the United States'

Somebody is going to look foolish in a week. A slightly safer bet would have been NY.

Current reporting from concerning another country where some have repeatedly announced that they see the curve bending. www.washingtonpost.com/world/2020/04/08/coronavirus-latest-news/ Spain’s Health Ministry said Wednesday there were 6,180 new confirmed of the cases of Covid-19, a 4.4 percent growth over the last 24 hours, as the government insisted the situation is slowly improving.

Spain began the week on a bright note with just a 3 percent increase in the number of cases, but as the days have gone by, the rate of growth has inched up slowly once more. There are a total of 146,690 cases — the most in Europe. Another 757 deaths, were also announced bringing the total to 14,555 — compared to 743 the day before and just 637 on Monday.

Spain’s Health Minister Santiago Illa insisted the numbers showed a “stabilization and flattening of the curve” and compared the figures to the 7 percent growth in new cases from last week and the 15 percent from the previous week.

“The numbers confirm we have reached the peak and are in the slowdown,” he said in a presentation before Spain’s parliament that is set to debate the government’s request to extend the state of emergency through April 26.

Spain’s restrictions are some of the most severe in Europe, with all nonessential activity on hold, parks and public areas closed and outings limited to one person per family for groceries or other necessities.

*One should note that the U.S. as a whole is far from a Spanish style lockdown, and from a certain perspective, of course the Spanish curve is bending. Absolute numbers, on the other hand most certainly aren't - the last time Spain had less than the current death total was March 25, and March 22 is the last time Spain had less than 5000 new cases a day. www.worldometers.info/coronavirus/country/spain/ provides an excellent overview of country data.

But like the Spanish, who some day will be past the first pandemic wave (they have been hoping soon since roughly March 29), this will be true in the U.S. too.

The virus cares nothing about predictions, of course.

It will be nice when we can finnaly look back at our ruined world and listen to the people who ruined it explain how they were just being prudent.

Andrew, it must really, really suck to be you.

I'd add:
Assigned workspaces.
Teachers changing classrooms instead of students (assuming schools reopen in the fall).

The K-12 schools systems are going to have to come up with protocols of what to do when a teacher/bus driver/aide turns positive. Even though children are at the lowest risks of dying, it seems to really scare parents if a teacher turns positive.

Do they close the school for two weeks? Do they test all of the students/employees? How will tracing/testing/isolation work for the children of blue collar parents?

Shut the school, isolate and test the families for two weeks. The blue collar parents need to miss work and the white collar parents need to work from home. It sucks, but it's a heckuva lot better than a national lockdown.

We need to get into a mode where the shutdowns are as small and local as possible. But getting there means lots of testing and being willing to shut things down rapidly. Over-react locally so you can under-react nationally.

We probably need some intermediate form of alternate child care in the very short term. Lots of essential workers have kids.

So you might put kids into daycares where they stay in a room with the same staff all day. Maybe even boarding overnight for kids who are old enough? I don't know right now.

California is already doing something like this https://www.abc10.com/article/news/health/coronavirus/free-childcare-for-essential-workers-during-coronavirus-pandemic-sacramento/103-8bdb1e61-cdcf-44a8-9b97-0e712877ca1c. Kids are kept in groups of no more than 10. I hope the groups are kept constant from day to day.

So we might be able to do something like that when we get a local breakout.

Obviously, when everything is considered, public education should be over and done with. There's no valid reason why a parent should be forced to send their child to a venue that can't guarantee their safety from pathological shooters, head lice or infectious diseases.

Is there a reason that no one is advocating hand washing stations at the entrances of businesses open to the public? What am I missing?

Lidl is already doing this, one assumes Europe wide.

Hats off to Lidl. Thanks for the info!

Those are routine at the entrances to food plants even for construction entrances when they are shut down.

Hand cleaning stations are all over cruise ships too - did not seem to make much difference, actually.

That's because cruise ships recycle a ton of air, from what I heard, not because everybody touches the same surfaces (they don't).

Did people consistently use them? Were they mandatory with someone watching to make sure that everyone going in used them?

You'll get kicked off site for not using them at a food plant, even if you just walked out for a "moment" or just washed your hands leaving the bathroom.

It always seems a little silly at first to go out to use the bathroom, wash your hands, walk down the hall to the production entrance and wash your hands again. But by being strict you catch all of the people who weren't diligent.

On the cruises I have sailed, hand washing stations were only outside the buffetts. In the dining rooms, we were offered a disinfecting wipe. Neither option was available at a la carte stations, nor at the bars.

"Masks for workers."

What masks? Whose? Where? How many for how much?

Where is the first Hanes mask? Are all the 3M-manufactured N95 masks being kept in Minnesota? Honeywell manufactures air filters: is Honeywell producing air filtration masks?

Masks? What masks? Whose? Where?

One assumes that all cashiers at all open stores at least have the sort of plexiglass protection that has become standard in European countries where the pandemic is spreading at a high rate. It really shouldn't be too hard to do that, to provide at least some level of protection for those working a register.

Oh yet another passive aggressive sneering remark towards America from prior. Are you paid by the post? Or does your grudge define you?

Or another example of how country after country do not use available time to prepare themselves for a novel pandemic by learning from countries that have already experienced its effects.

These are safety protocols involving being at work right now, like the Lidl hand cleaning stations outside stores, not something to do in the future.

"Or another example "

Yes, another example of you being:
a) passive aggressive/condesending "One assumes"
b) always trying to fault the US "has become standard in European countries"
c) "attempts to deny" that the statement is meant precisely that way in a follow up post, despite the last 100+ posts that followed the same m. o.

At this point the question is not "where are the masks".
It's "why are the medical workers not on strike?"

Maybe the U.S. is benefitting from paying their healthcare workers at a higher rate than most other industries. Any nurse who refused to work would basically never work as a nurse again. Than then what would that nurse do to make the same amount of money.

Healthcare workers are scared and working hard to keep from getting infected. Many of them know to avoid older relatives and friends until this is over. Some of them are not going home to avoid infecting their families.

Snarky answer: It would be like the Army going on strike over risk of death during wartime.

Possibly also relevant: the President has the discretion to order workers in critical industries back to work.

Do you really think that a timid, indecisive, and weak leader such as President Trump would ever try to force nurses back to work at a particular hospital.

What will make healthcare provider walk away at any particular facility will be inept management of a hospital that kills moral and endangers the workers.

Trump has no authority over state licensing requirements. Many states have a policy that RNs who don't want to work during the COVID crisis will not have their licenses renewed. This means a 75% pay cut for them when they try to work in paranursing jobs. They'll go to work.

Just put a max flow feminine sanitary pad over your face.

I would not assume anything about China at this point. Their numbers cannot be trusted.

Masks don't protect the wearer, masks protect others from the wearer (because the wearer may be infected and not know it). CDC is being intentionally vague as to the reason the CDC is recommending everyone wear a mask: would one wear a mask if the point is not to protect the wearer but to protect others from the wearer?

Wrong.

N95 masks do prevent the wearer

If you have some N95s to spare, I will take a couple hundred.

Some masks are made to protect the wearer. N95 is probably in that category. Many have valves to allow your exhales to escape unfiltered.

Other masks are made to protect people from you. Like hair nets in a food facility. They aren't there to protect your hair!

Surgical/medical masks protect the wearer.
CDC is being vague to save face.

They are endangering lives to save face.

My suspicion is that when this is all over there will be multiple published studies that say the transmission from fomites (surfaces) was never more than 5% of total infections.

It will never make the front page news. No one will care.

Actually, there is evidence that the size of the viral load you get has an effect on how bad the symptoms are. So a mask that stops even 50% of the virus (i.e. a surgical mask) could mean the difference between a mild and severe case, or a severe case and death.

> several large serological surveys are already underway which will gives us a much better idea of how widely the virus has spread.

Maybe...

"Coronavirus: low antibody levels raise questions about reinfection risk"
https://www.scmp.com/news/china/science/article/3078840/coronavirus-low-antibody-levels-raise-questions-about

"A team from Fudan University analysed blood samples from 175 patients discharged from the Shanghai Public Health Clinical Centre and found that nearly a third had unexpectedly low levels of antibodies. In some cases, antibodies could not be detected at all."

There are other articles noting similar findings. And this study was of people admitted to the hospital with serious symptoms. People with minor or no symptoms might have an even lower positive testing rate. You are pinning your strategy on tests which have much lower sensitivity and specificity than you seem to believe. Biology is far messier than we care to admit. I am really concerned that the elite consensus which is pushing this "test, trace, isolate, immune certificate" line of attack is going to be discredited when testing turns out not to be up to the task.

By all means test away, it is essential. But do not oversell the results of the tests before we have a solid understanding of the limits of the tests. And please be careful formulating and promoting strategy based on tests with poorly understood capabilities.

https://twitter.com/EricTopol/status/1247888361219473409

https://blogs.sciencemag.org/pipeline/archives/2020/04/08/covid-19-antibody-update-for-april-8

"A lot of people are (understandably) talking about having some sort of “immunological passport” system to clear people for work, etc. before we are able to vaccinate the population, and these results may be telling us that that will be a complicated process, one that might not clear as many people as one would hope."

Aaron Carroll on how we will know when it's time to go back to work: https://www.nytimes.com/2020/04/06/upshot/coronavirus-four-benchmarks-reopening.html

"Experts say..." is another causality of coronavirus. The virus has demonstrated that the competency crisis among elites is all too real.

No need to limit it to elites.

This is a grand societal failure from the kids at spring break to the politicians tweeting which movies to see in NYC mid March to the WHO.

https://hotair.com/headlines/archives/2020/04/its-come-to-this-729/

Aerial footage above South Florida shows hundreds of residents risking possible coronavirus exposure — lining up to get paper applications for unemployment benefits as the state tries to fix problems with online filing.

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This is all abstract tree applied to a value added chain, state government. We have to make this tree trunk round, force the queue into independent Gaussian arrivals.

https://www.alt-m.org/2020/04/07/when-the-waterbed-bursts/
When the Waterbed Bursts
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Another tree trunk problem. The new mortgage regulations caused risk to be shifted to a mortgage service company that was immune from regs. Now the mortgage service companies are jammed with financial liabilities.

This is another in a long line of regulations that do not fix the problem but just add layers of unnecessary processing in the chain. Most of the bailouts we suffer are bailouts of the previous unsustainable bailouts, it become a repetitive cycle when the tree trunk is not round.

https://slate.com/news-and-politics/2020/04/this-is-ridiculous-wisconsin-election-photo-interview.html

Milwaukee residents waited between 90 minutes and 2½ hours to vote on Tuesday, after a coronavirus-induced poll worker shortage forced the city to reduce 180 polling places to just five and a last-ditch effort by the state’s governor to postpone the election was overturned by the state Supreme Court.

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Yet another value chain foul up. Repubs did this and are as bad at it as the Dems. Politicians and administrators everywhere creating more congestion, more spread. Happens every recession, or paraphrasing Buffet: When the water level goes down we can see the congestion.

Good thoughts and a good post!!

Other safety protocols include:

Stuff that could conceivably be useful even if there's no proof that it helps at all. It could work. Might as well try it. Exactly the same line of thinking that created the "cargo cults" in New Guinea.

Happy to hear Alex talking sense. We disagree on the past but at least we can agree on the path forward.

A haphazard plan can get a lot of people killed. Yesterday, Covid-19 claimed more American lives than the pre-Covid top three killers combined in a day.

"China bent the curve"

sure, sure. They hit 80,000 beginning of March and took 19 days to reach 1,000. That is not bending, that is running the curve over with a steamroller.

In other words, its not true at all that China bent the curve. Or at least we have no idea but its a safe bet they are lying.

China has nothing to do with this, other than being another place where people get the croup. Yeah, that's right the croup. It's been around forever and has nothing to do with eating bats or pangolins. It's time to get in touch with reality.

"test, trace and isolate"

Sorry, but not only has that time passed, it isn't possible with SARS 2.0. SARS 2.0 if very influenza like in transmission. It is transmissible for days before symptoms present, even longer before fever. And all this presumes they find that surface transmission is no greater than seasonal flu meaning we can, keep washing our hands, but no longer fear every object in public.

In any case, we are going to see sharp declines in productivity and many former businesses are going to find their business model is not viable under those conditions and to save what the wealth the small business owner already has, they should shutdown their business.

This SARS 2.0 will eventually slip into the background like common influenza, rhinoviruses, etc. But that requires one therapeutics to treat those who develop serious cases and hopefully a vaccine, as we do with annual flu.

SARS 1.0 was controllable because it wasn't transmissible until a few days after symptoms presented. Also, the animal source was identified and destroyed. In contrast, MERS was shifted to the background, but there was no way that millions of camels in the ME were going to be destroyed. But identify, trace and isolate worked because the symptoms revealed before transmission.

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