What next, reorientation April 24 2020

[This entry is still unfinished.
But I’m publishing as-is, and will finish it later.

Why?
Because I went shopping yesterday.
And that makes me think: What if I catch it now?
So I’m learning to act “as if”.

I plan in terms of incubation periods.
“What if I fall ill in a few days?”
So I try to be effective sooner rather than later.
I’m a *$%& catastrophologist, right? :-)]



ORIENTATION

"Orientation is *hard*." -- Vinay Gupta.
Orientation is step 2 of the OODA loop (John Boyd).
We do Observation, Orientation, Decision & Action.

If we're crossing the street, we
1) Observe the incoming cars & the light & the weather,
2) Orient ourselves by taking into account the strength of our legs and the weight we're carrying,
3) Decide to walk,
4) Act by walking,
and of course we keep our eyes open so we go back to Observation.

Orientation is generally the most difficult element of the loop.
It's difficulty increases with the complexity and unpredictability of the situation.

And now we're in this coronavirus pandemic.
It started about 100 days ago.
And if feel it started ages ago.
Before, you know, “all this”.

AN ENTRY POINT FOR UNDERSTANDING

If we are looking at a complex picture, we need some sort of frame.
We start somewhere.
What could be a good starting point to understand this?

The main thing we need to understand is "contagion".
There's this virus, that jumps from one person to the other.
From A to B.
Let's call them Alice and Bob.

Alice has been in contact with people in these past few days.
We're talking effective contact.
Effective from the point of view of the virus.
Contact meaning the virus has the chance to go from Alice to Bob.

What we accept is that this happens when:
a) Alice breathes into a space, Bob breathes in the same space.
b) Alice drops the virus on surfaces, Bob touches those surfaces, Bob touches his face.

You will hear countless conversations trying to determine the parameters of those two situations.
Does the virus float in the air for very long?
Does it stay on surfaces for very long?
How many particles of the virus are needed for Bob to become infected?
But those details, to a certain extent, don't matter.

CONTACT TRACING

What matters is that, generally speaking, we don't know when that happened.
You see: Bob, in the past week or so, has had a number of "contacts".
Did Bob get it from Alice, Albert, Anne or Arnold?

It also matters that after getting infected, Bob continued to meet people.
He went near Charles, Clare, Constance and Collin.

We're not interested in being sure.
We're interested in doing our best to stop this, or at least slow it down a lot.
- Because slowing this down means health care and societies are not so overwhelmed at any point in time.
- Because we buy time to develop better strategies, better treatments, maybe even vaccines.
- Because slowing this down means outbreaks don’t “overshoot”.
(Meaning they don’t infect more population than what’s needed for a possible situation of “herd immunity”, itself a can of worms, so please excuse me if we don’t go into this.)

So we start with Bob.
Because he's now ill.
Or because we've found he's infected through some kind of test or enquiry.

In any case, we now want to get in touch with all 8 of them.
We're hoping to find that one of the first 4 passed it on to Bob.
We also need to check that the second 4 haven't been infected by Bob.

ISOLATION

Let's say we find that Alice & Arnold, and Collin, have the virus.
If that's the case, then all 4 (Bob, Alice, Arnold & Collin) should go into “isolation”.
(“Isolation” is the name we give this when the person is ill.)

We do this well.
Because we're good people, kind to each other. This could be any of us.
And, also, as a society, we want this to work.

So we make it possible, easy, even comfortable, to be isolated:
If they needed to work to make money for themselves & their families, we help out.
We do the shopping for them.
We bring them whatever medication they may need.
We give them shelter if they are homeless.
We help them to stay apart from the people they used to stay with, but connected with them.
With kind explanations, and practical assistance, to everyone affected by this.

Two final bits on isolation.
Two important bits:
- We do this inside the home.
- We help people isolate outside the home.

1) xxx

2) xxx

QUARANTINE

What about the others: Albert, Anne, Charles, Clare & Constance?

They should go into quarantine.
Same thing, except they don't have the virus.
Or we don't know.
So, in practical terms, same thing.
Except they don’t need treatment, at least yet.
(This is called “quarantine”, not “isolation”.)

Again, with abundance of kindness.

THE WIDER PICTURE

If any of the “contacts” ends up being a “case”, we start over with each of them.
As they say, “it’s a process”.
A whole lot of work.

Needs people who are trained, supported, resourced and supervised.

1) Trained, preferably, with open-source, widely available materials.
Because the whole of humanity is needing these activity of “contact tracing”.
Because we all benefit if everyone else benefits.
Because human life and systemic effects matter.
Because we can do it and we can do it well.

(I’ll collect some resources, but give me more on twitter @lucasgonzalez.
Thanks.)

2) Supported, with those doing this kind of work being
clothed & sheltered,
fed & watered,
cared for & protected as needed
(see resiliencemaps.org).

3) Resourced, with workers being xxx

4) Supervised, xxx

AND THE OTHERS?

Some of the people will have been infected but have no symptoms.

How many of those are around?
We don't know.
They might be important in how this epidemics evolve.
Even if each of them doesn’t pass it on much.
Because a healthy carrier is, well, healthy.
They, we, walk around, meet people, etc.

So we have two things that we try to do with those (of us).

REDUCE CONTACTS

No, don't call it "social distance".
It doesn't get better if it's further away.
It's not measured in meters, yards, or alligators.

Call it "contact reduction", because that is what it is.
You want _each person_ to _meet less different people_.

Example:
IF your family or tight group doesn't have the virus,
AND you have respiratory contacts every single day,
with your family or tight group ONLY.
Contacts that would effective from the point of view of the virus,
if it were there (but it isn't).
AND no-one in the group ever has contact (respiratory or surfaces) with others.
Then that group is fine.

This cannot be sustained for long periods.
But it’s useful as containment.
So use it as one more strategy.

MAKE CONTACTS LESS EFFECTIVE

Again, "effective" is from the point of view of the virus.

Wear masks.
Goggles if you have them.
One of those to-become-fashionable helmets or air-conditioned hoods.

And wash your hands as recommended.
Maybe using tippy tap or better.

Everyone who goes out.
Everyone who is at home caring for someone who's ill.

Because this is not about Alice and Bob.
This is about Alice … and Zoe.

Let me slow this down, because I was slow to get it.
And because it matters.

It _is_ true that masks are less than perfect.
People can use them badly, if they don’t know.
People can use them badly, if not well trained.
People can use them badly, if tired.

Same with hand washing.
How many people do it well, really?

So teach, train, facilitate rest.
Take a break yourself.

Because this is what happens if _as many people as possible_ apply these strategies.
What happens is that Alice is less likely to pass it on to Bob.
Bob is less likely to pass it on to Charlotte.
And so on, until, eventually, Zoe is _way_ more protected than she would be without all those layers.
IF most of the people in the chain do their job.

So thank you for doing it,
and for helping others do it.
Kindly and effectively.
Really, thank you.