Quote: @purplefaithful said:
A VERY GOOD interview with Michael Osterholm Infectious Disease Expert. This is just a part of it (link below)
=============================
BERGEN: What should that long-term strategy look like?
OSTERHOLM: The first step is to acknowledge the need for a long-term strategy. We're so focused on "the here and now" of this issue -- the idea of just getting over this wave and flattening this curve. And I agree with that. It's an immediate issue, particularly if you are in one of the places that's on fire right now like New York, Detroit, Chicago, New Orleans. But people have handled these local hot spots almost like they were faced with a hurricane that has now made landfall. Now we can get into remediation and recovery from this first round of crisis.
So, the first thing we need is a plan. That's critical.
The second thing we need to address is: What is our long-term strategy? I believe we have really two choices at the edges and some additional options in between. One choice is to try to lock down our society and economy like Wuhan did. Most of us understand that adopting that approach means we're not only destroying the economy but also destroying society as we know it.
The other alternative is to let viral transmission go willy-nilly until it burns through the population. I am strongly against that approach for two reasons. First, that would mean we could potentially experience millions of deaths just in the United States. It would bring down our health care system as we know it; it would mean severely compromised care for Covid-19 patients and fewer care options for anyone else with other serious health issue such as a heart attack, acute asthma attack, cancer or an injury from an accident. So, that is not a viable alternative.
There's got to be an approach in the middle. I call it "threading the rope through the needle," where we open our economy and everyday life in a way that is capable of rapidly detecting the emergence of new waves of infection. Then we do whatever we can again with physical distancing to limit the new infection's spread.
By the way, I find the term "social distancing" unfortunate. It is physical distancing that we need in order to stop the virus transmission.
Let's never social distance. Let's try in our modern age of the Internet, to do a better job with staying social.So how do we get the younger, otherwise healthy demographic back to work, a group we know will be at much lower risk of serious disease and death if they get infected? How do we bring a substantial number of these individuals back into society and at the same time try to protect those who have the highest risk of a severe outcome?
Remember we have to get them through the next 16 to 20 months, or until we get a safe and effective vaccine.
For those who are vulnerable, it is imperative that we minimize the risk of infection and the likelihood of ending up in a hospital and dying. And please know this approach will never be perfect; some younger people will get sick and even die. But the rate of serious illness and deaths will be many times lower for the young than for older individuals or those with underlying health risk factors.
Our strategy can't be the outcomes of day-to-day press conferences. It can't be 30-day plans to "social" or "physically" distance. It's got to address how we're going to incorporate day-to-day prevention actions, and what we ask the public to do must be realistic.
For example, everybody wants to do widescale coronavirus testing today. Talking heads without any experience in testing declare, "We'll test millions of people each week, and then we'll know who is infected and can follow up." Very few people realize that the testing community in this country can't do that. We don't have adequate international manufacturing capacity and supply chains for reagents, the chemicals needed to run these tests.
The reagent capability -- meaning securing those chemicals that are key for running many of these tests, whether you're testing for virus or antibody -- before the pandemic was more or less, adequately supported by a "garden hose of production." Then Covid-19 came along and the Asian countries, specifically China, demanded a major increase in reagent supplies.
No matter how you slice it, on the most basic back-of-the-envelope estimate, this is a really bad situation.
Finally, the whole world caught the pandemic, and now there are billions of people who need to be tested. We need a firehose to meet that demand but we can't build reagent manufacturing facilities overnight. I urge that whatever we do going forward has to be based on reality. We're not going to test your way out of this thing when we don't have tests.
I paraphrase a quote from former US Secretary of Defense (Donald) Rumsfeld who said, "When you go to war, you don't get to go with what you want. You have to go with what you have."
So, we're going to have this reagent issue for some time to come, and we must understand that and come up with a plan based on reality.
https://www.cnn.com/2020/04/21/opinions/...index.html
pretty much echos what I have read and what needs to be understood by all.
1. Controlled reopening of economy with a plan in place for rapid responses and re-closures of the micro breakouts (like in Sioux Falls or similar situations)
2. Law of average testing, the tests need to be done randomly and use math to calculate out from there the potential for any given area or demographic.
3. Most imporantly, this thing isnt going away until an anti virus is discovered, developed, and mass distributed, we are going to live with this thing for at a minimum of another 12 months and most likely more. Start to return to life but a new normal must be established to maintain the safe spacing and other practices we are currently doing.
Quote: @bigbone62 said:
@ Hidalgo said:
This is from a co-worker that tested positive:
Words from the IDPH. The organization that is supposed to care about our health, is also the same organization that is telling my fiancé that he can go back to work tomorrow.... as a CNA... at a NURSING HOME!!!
Because the “health care workers are exceptions to the Health department’s rules”
“As long as he doesn’t have a fever, he’s fine” (even though I never had a temp over 99.7)
Even though he is a household contact with a positive COVID-19 case (me) and my symptoms aren’t gone, and the health department recommended he stayed in quarantine.
Is the state really protecting the vulnerable? The at risk? Shouldn’t health care workers be isolated LONGER, not shorter? Especially when they’re around ELDERLY PEOPLE!
The symptoms, the regulations, the “numbers” and predictions have been contradicting this whole time.
If healthcare workers were not the exceptions to these rules far more than just people who catch COVID-19 would be dying off. If everyone of my co-workers or myself stayed home and quarantined because we were exposed to someone with it there wouldn't be anyone running the hospitals or clinics. Company policy dictates a specific department reaches out to employees to inform them they have been exposed to someone with COVID-19. People now send those calls direct to VM and delete messages without listening because there isn't enough time to do the job and waste time talking to HR.
I don't know being in that position is the result of being reactive and falling behind the curve. Managing the situation has to be better than that.
Quote: @JimmyinSD said:
@ purplefaithful said:
A VERY GOOD interview with Michael Osterholm Infectious Disease Expert. This is just a part of it (link below)
=============================
BERGEN: What should that long-term strategy look like?
OSTERHOLM: The first step is to acknowledge the need for a long-term strategy. We're so focused on "the here and now" of this issue -- the idea of just getting over this wave and flattening this curve. And I agree with that. It's an immediate issue, particularly if you are in one of the places that's on fire right now like New York, Detroit, Chicago, New Orleans. But people have handled these local hot spots almost like they were faced with a hurricane that has now made landfall. Now we can get into remediation and recovery from this first round of crisis.
So, the first thing we need is a plan. That's critical.
The second thing we need to address is: What is our long-term strategy? I believe we have really two choices at the edges and some additional options in between. One choice is to try to lock down our society and economy like Wuhan did. Most of us understand that adopting that approach means we're not only destroying the economy but also destroying society as we know it.
The other alternative is to let viral transmission go willy-nilly until it burns through the population. I am strongly against that approach for two reasons. First, that would mean we could potentially experience millions of deaths just in the United States. It would bring down our health care system as we know it; it would mean severely compromised care for Covid-19 patients and fewer care options for anyone else with other serious health issue such as a heart attack, acute asthma attack, cancer or an injury from an accident. So, that is not a viable alternative.
There's got to be an approach in the middle. I call it "threading the rope through the needle," where we open our economy and everyday life in a way that is capable of rapidly detecting the emergence of new waves of infection. Then we do whatever we can again with physical distancing to limit the new infection's spread.
By the way, I find the term "social distancing" unfortunate. It is physical distancing that we need in order to stop the virus transmission.
Let's never social distance. Let's try in our modern age of the Internet, to do a better job with staying social.So how do we get the younger, otherwise healthy demographic back to work, a group we know will be at much lower risk of serious disease and death if they get infected? How do we bring a substantial number of these individuals back into society and at the same time try to protect those who have the highest risk of a severe outcome?
Remember we have to get them through the next 16 to 20 months, or until we get a safe and effective vaccine.
For those who are vulnerable, it is imperative that we minimize the risk of infection and the likelihood of ending up in a hospital and dying. And please know this approach will never be perfect; some younger people will get sick and even die. But the rate of serious illness and deaths will be many times lower for the young than for older individuals or those with underlying health risk factors.
Our strategy can't be the outcomes of day-to-day press conferences. It can't be 30-day plans to "social" or "physically" distance. It's got to address how we're going to incorporate day-to-day prevention actions, and what we ask the public to do must be realistic.
For example, everybody wants to do widescale coronavirus testing today. Talking heads without any experience in testing declare, "We'll test millions of people each week, and then we'll know who is infected and can follow up." Very few people realize that the testing community in this country can't do that. We don't have adequate international manufacturing capacity and supply chains for reagents, the chemicals needed to run these tests.
The reagent capability -- meaning securing those chemicals that are key for running many of these tests, whether you're testing for virus or antibody -- before the pandemic was more or less, adequately supported by a "garden hose of production." Then Covid-19 came along and the Asian countries, specifically China, demanded a major increase in reagent supplies.
No matter how you slice it, on the most basic back-of-the-envelope estimate, this is a really bad situation.
Finally, the whole world caught the pandemic, and now there are billions of people who need to be tested. We need a firehose to meet that demand but we can't build reagent manufacturing facilities overnight. I urge that whatever we do going forward has to be based on reality. We're not going to test your way out of this thing when we don't have tests.
I paraphrase a quote from former US Secretary of Defense (Donald) Rumsfeld who said, "When you go to war, you don't get to go with what you want. You have to go with what you have."
So, we're going to have this reagent issue for some time to come, and we must understand that and come up with a plan based on reality.
https://www.cnn.com/2020/04/21/opinions/...index.html
pretty much echos what I have read and what needs to be understood by all.
1. Controlled reopening of economy with a plan in place for rapid responses and re-closures of the micro breakouts (like in Sioux Falls or similar situations)
2. Law of average testing, the tests need to be done randomly and use math to calculate out from there the potential for any given area or demographic.
3. Most imporantly, this thing isnt going away until an anti virus is discovered, developed, and mass distributed, we are going to live with this thing for at a minimum of another 12 months and most likely more. Start to return to life but a new normal must be established to maintain the safe spacing and other practices we are currently doing.
Agreed, I hope you read the whole thing and everyone else does too - in spite of all of our Covid burn-out.
One of the better informative and strategic perspectives - from a very learned man.
We're at the end of the first baseball inning, long ways to go.
Quote: @bigbone62 said:
@ JimmyinSD said:
@ bigbone62 said:
@ Hidalgo said:
This is from a co-worker that tested positive:
Words from the IDPH. The organization that is supposed to care about our health, is also the same organization that is telling my fiancé that he can go back to work tomorrow.... as a CNA... at a NURSING HOME!!!
Because the “health care workers are exceptions to the Health department’s rules”
“As long as he doesn’t have a fever, he’s fine” (even though I never had a temp over 99.7)
Even though he is a household contact with a positive COVID-19 case (me) and my symptoms aren’t gone, and the health department recommended he stayed in quarantine.
Is the state really protecting the vulnerable? The at risk? Shouldn’t health care workers be isolated LONGER, not shorter? Especially when they’re around ELDERLY PEOPLE!
The symptoms, the regulations, the “numbers” and predictions have been contradicting this whole time.
If healthcare workers were not the exceptions to these rules far more than just people who catch COVID-19 would be dying off. If everyone of my co-workers or myself stayed home and quarantined because we were exposed to someone with it there wouldn't be anyone running the hospitals or clinics. Company policy dictates a specific department reaches out to employees to inform them they have been exposed to someone with COVID-19. People now send those calls direct to VM and delete messages without listening because there isn't enough time to do the job and waste time talking to HR.
valid point, I would wonder if nursing home workers should be the exception though. most all NHs have been on lock down for a while now and have taken extreme precautions to keep their employees clear and their inmates safe (I cant remember what people that live there are called) I can see in hospital or clinical settings telling the staff to keep coming to work as long as they are able because that is where everybody is pretty much exposed, but I would still think staff at dedicated nursing homes would be self reporting and be told to quarantine if they know they have been exposed.
I think people would be floored if they knew how many nursing homes and RCF's are essentially hiding outbreaks (3 or more clients or staff is an outbreak). A local RCF announced several weeks ago there was an outbreak. Announcement was on a Thursday, that following Monday it was given the all clear because the impacted patients and one staff had been been quarantined for 2 plus weeks at that point and were either symptom free or moved. So that means they sat on it for 1.5 weeks before telling the public. Same thing happened at 2 nursing homes near us.
That said same thing applies for nursing homes as hospitals and clinics, if people didn't come in due to exposure there wouldn't be the people to do the work. Its hard enough to staff nursing homes that are county run or for low income clients. Which is were a lot of these national outbreaks are happening. Now try and find staff when there are rampant reports of nationwide outbreaks in nursing homes and you are hiring them because you have a staff storage due to COVID-19 quarantining. Obviously in nursing homes as with hospitals and clinics there are none essential employees that self reporting and staying home can work with.
I know the home my SIL works at up here was very pro active. once there was a confirmed case in the US they made every employee that had been out of SD quarantine for 2 weeks before returning to work, which really amped up the work load for the rest since Feb is usually when most northerners take their winter get aways, a lot of their staff was out. IIRC they then had to start showering in/out of work, their scrubs are laundered on site now, temps taken before being allowed into the building and a bunch of other shit.
on a side note, one thing that should be thought about for all these front line people and all the extra hours they are working... the affects it is having on their marriages. I know sometimes the irregular shifts at HC facilities puts strains on relationships, but what has been asked of some of these providers in the last few months has been crushing for some. especially if the spouse is at home alone and bored all day.
Quote: @purplefaithful said:
@ JimmyinSD said:
@ purplefaithful said:
A VERY GOOD interview with Michael Osterholm Infectious Disease Expert. This is just a part of it (link below)
=============================
BERGEN: What should that long-term strategy look like?
OSTERHOLM: The first step is to acknowledge the need for a long-term strategy. We're so focused on "the here and now" of this issue -- the idea of just getting over this wave and flattening this curve. And I agree with that. It's an immediate issue, particularly if you are in one of the places that's on fire right now like New York, Detroit, Chicago, New Orleans. But people have handled these local hot spots almost like they were faced with a hurricane that has now made landfall. Now we can get into remediation and recovery from this first round of crisis.
So, the first thing we need is a plan. That's critical.
The second thing we need to address is: What is our long-term strategy? I believe we have really two choices at the edges and some additional options in between. One choice is to try to lock down our society and economy like Wuhan did. Most of us understand that adopting that approach means we're not only destroying the economy but also destroying society as we know it.
The other alternative is to let viral transmission go willy-nilly until it burns through the population. I am strongly against that approach for two reasons. First, that would mean we could potentially experience millions of deaths just in the United States. It would bring down our health care system as we know it; it would mean severely compromised care for Covid-19 patients and fewer care options for anyone else with other serious health issue such as a heart attack, acute asthma attack, cancer or an injury from an accident. So, that is not a viable alternative.
There's got to be an approach in the middle. I call it "threading the rope through the needle," where we open our economy and everyday life in a way that is capable of rapidly detecting the emergence of new waves of infection. Then we do whatever we can again with physical distancing to limit the new infection's spread.
By the way, I find the term "social distancing" unfortunate. It is physical distancing that we need in order to stop the virus transmission.
Let's never social distance. Let's try in our modern age of the Internet, to do a better job with staying social.So how do we get the younger, otherwise healthy demographic back to work, a group we know will be at much lower risk of serious disease and death if they get infected? How do we bring a substantial number of these individuals back into society and at the same time try to protect those who have the highest risk of a severe outcome?
Remember we have to get them through the next 16 to 20 months, or until we get a safe and effective vaccine.
For those who are vulnerable, it is imperative that we minimize the risk of infection and the likelihood of ending up in a hospital and dying. And please know this approach will never be perfect; some younger people will get sick and even die. But the rate of serious illness and deaths will be many times lower for the young than for older individuals or those with underlying health risk factors.
Our strategy can't be the outcomes of day-to-day press conferences. It can't be 30-day plans to "social" or "physically" distance. It's got to address how we're going to incorporate day-to-day prevention actions, and what we ask the public to do must be realistic.
For example, everybody wants to do widescale coronavirus testing today. Talking heads without any experience in testing declare, "We'll test millions of people each week, and then we'll know who is infected and can follow up." Very few people realize that the testing community in this country can't do that. We don't have adequate international manufacturing capacity and supply chains for reagents, the chemicals needed to run these tests.
The reagent capability -- meaning securing those chemicals that are key for running many of these tests, whether you're testing for virus or antibody -- before the pandemic was more or less, adequately supported by a "garden hose of production." Then Covid-19 came along and the Asian countries, specifically China, demanded a major increase in reagent supplies.
No matter how you slice it, on the most basic back-of-the-envelope estimate, this is a really bad situation.
Finally, the whole world caught the pandemic, and now there are billions of people who need to be tested. We need a firehose to meet that demand but we can't build reagent manufacturing facilities overnight. I urge that whatever we do going forward has to be based on reality. We're not going to test your way out of this thing when we don't have tests.
I paraphrase a quote from former US Secretary of Defense (Donald) Rumsfeld who said, "When you go to war, you don't get to go with what you want. You have to go with what you have."
So, we're going to have this reagent issue for some time to come, and we must understand that and come up with a plan based on reality.
https://www.cnn.com/2020/04/21/opinions/...index.html
pretty much echos what I have read and what needs to be understood by all.
1. Controlled reopening of economy with a plan in place for rapid responses and re-closures of the micro breakouts (like in Sioux Falls or similar situations)
2. Law of average testing, the tests need to be done randomly and use math to calculate out from there the potential for any given area or demographic.
3. Most imporantly, this thing isnt going away until an anti virus is discovered, developed, and mass distributed, we are going to live with this thing for at a minimum of another 12 months and most likely more. Start to return to life but a new normal must be established to maintain the safe spacing and other practices we are currently doing.
Agreed, I hope you read the whole thing and everyone else does too - in spite of all of our Covid burn-out.
One of the better informative and strategic perspectives - from a very learned man.
We're at the end of the first baseball inning, long ways to go.
I made it through the whole thing, now that VA study posted last night.. I quit reading after about 20 pages or so, but I had gotten the jist of it by then.
Quote: @BigAl99 said:
@ bigbone62 said:
@ Hidalgo said:
This is from a co-worker that tested positive:
Words from the IDPH. The organization that is supposed to care about our health, is also the same organization that is telling my fiancé that he can go back to work tomorrow.... as a CNA... at a NURSING HOME!!!
Because the “health care workers are exceptions to the Health department’s rules”
“As long as he doesn’t have a fever, he’s fine” (even though I never had a temp over 99.7)
Even though he is a household contact with a positive COVID-19 case (me) and my symptoms aren’t gone, and the health department recommended he stayed in quarantine.
Is the state really protecting the vulnerable? The at risk? Shouldn’t health care workers be isolated LONGER, not shorter? Especially when they’re around ELDERLY PEOPLE!
The symptoms, the regulations, the “numbers” and predictions have been contradicting this whole time.
If healthcare workers were not the exceptions to these rules far more than just people who catch COVID-19 would be dying off. If everyone of my co-workers or myself stayed home and quarantined because we were exposed to someone with it there wouldn't be anyone running the hospitals or clinics. Company policy dictates a specific department reaches out to employees to inform them they have been exposed to someone with COVID-19. People now send those calls direct to VM and delete messages without listening because there isn't enough time to do the job and waste time talking to HR.
I don't know being in that position is the result of being reactive and falling behind the curve. Managing the situation has to be better than that.
Nothing to do with being behind the curve. Being behind the curve isn't what caused a state wide medical professional shortage years ago. Hard to be anything but reactive when you are down manpower even before losing your first employee to quarantine or illness.
Quote: @JimmyinSD said:
@ bigbone62 said:
@ JimmyinSD said:
@ bigbone62 said:
@ Hidalgo said:
This is from a co-worker that tested positive:
Words from the IDPH. The organization that is supposed to care about our health, is also the same organization that is telling my fiancé that he can go back to work tomorrow.... as a CNA... at a NURSING HOME!!!
Because the “health care workers are exceptions to the Health department’s rules”
“As long as he doesn’t have a fever, he’s fine” (even though I never had a temp over 99.7)
Even though he is a household contact with a positive COVID-19 case (me) and my symptoms aren’t gone, and the health department recommended he stayed in quarantine.
Is the state really protecting the vulnerable? The at risk? Shouldn’t health care workers be isolated LONGER, not shorter? Especially when they’re around ELDERLY PEOPLE!
The symptoms, the regulations, the “numbers” and predictions have been contradicting this whole time.
If healthcare workers were not the exceptions to these rules far more than just people who catch COVID-19 would be dying off. If everyone of my co-workers or myself stayed home and quarantined because we were exposed to someone with it there wouldn't be anyone running the hospitals or clinics. Company policy dictates a specific department reaches out to employees to inform them they have been exposed to someone with COVID-19. People now send those calls direct to VM and delete messages without listening because there isn't enough time to do the job and waste time talking to HR.
valid point, I would wonder if nursing home workers should be the exception though. most all NHs have been on lock down for a while now and have taken extreme precautions to keep their employees clear and their inmates safe (I cant remember what people that live there are called) I can see in hospital or clinical settings telling the staff to keep coming to work as long as they are able because that is where everybody is pretty much exposed, but I would still think staff at dedicated nursing homes would be self reporting and be told to quarantine if they know they have been exposed.
I think people would be floored if they knew how many nursing homes and RCF's are essentially hiding outbreaks (3 or more clients or staff is an outbreak). A local RCF announced several weeks ago there was an outbreak. Announcement was on a Thursday, that following Monday it was given the all clear because the impacted patients and one staff had been been quarantined for 2 plus weeks at that point and were either symptom free or moved. So that means they sat on it for 1.5 weeks before telling the public. Same thing happened at 2 nursing homes near us.
That said same thing applies for nursing homes as hospitals and clinics, if people didn't come in due to exposure there wouldn't be the people to do the work. Its hard enough to staff nursing homes that are county run or for low income clients. Which is were a lot of these national outbreaks are happening. Now try and find staff when there are rampant reports of nationwide outbreaks in nursing homes and you are hiring them because you have a staff storage due to COVID-19 quarantining. Obviously in nursing homes as with hospitals and clinics there are none essential employees that self reporting and staying home can work with.
I know the home my SIL works at up here was very pro active. once there was a confirmed case in the US they made every employee that had been out of SD quarantine for 2 weeks before returning to work, which really amped up the work load for the rest since Feb is usually when most northerners take their winter get aways, a lot of their staff was out. IIRC they then had to start showering in/out of work, their scrubs are laundered on site now, temps taken before being allowed into the building and a bunch of other shit.
on a side note, one thing that should be thought about for all these front line people and all the extra hours they are working... the affects it is having on their marriages. I know sometimes the irregular shifts at HC facilities puts strains on relationships, but what has been asked of some of these providers in the last few months has been crushing for some. especially if the spouse is at home alone and bored all day.
This is not only going to ruin a lot of marriages but families in general. Our MHC is seeing an uptick in child referrals. Now part of that is kids are off school and med management and therapy can be done via phone of live streamed. So it's easier. But right now our most common reason for child referrals is "issues at home" which is code for mommy and daddy are the ones with the issue. I've got co-workers who haven't been home since the week before St. Patties day as they are staying in hotels out of fear they will bring this shit home. Think about that, the kids are home 24/7 during that time and dad hasn't been home in over a month. All kinds of unhealthy thoughts going through their minds.
Quote: @bigbone62 said:
@ BigAl99 said:
@ bigbone62 said:
@ Hidalgo said:
This is from a co-worker that tested positive:
Words from the IDPH. The organization that is supposed to care about our health, is also the same organization that is telling my fiancé that he can go back to work tomorrow.... as a CNA... at a NURSING HOME!!!
Because the “health care workers are exceptions to the Health department’s rules”
“As long as he doesn’t have a fever, he’s fine” (even though I never had a temp over 99.7)
Even though he is a household contact with a positive COVID-19 case (me) and my symptoms aren’t gone, and the health department recommended he stayed in quarantine.
Is the state really protecting the vulnerable? The at risk? Shouldn’t health care workers be isolated LONGER, not shorter? Especially when they’re around ELDERLY PEOPLE!
The symptoms, the regulations, the “numbers” and predictions have been contradicting this whole time.
If healthcare workers were not the exceptions to these rules far more than just people who catch COVID-19 would be dying off. If everyone of my co-workers or myself stayed home and quarantined because we were exposed to someone with it there wouldn't be anyone running the hospitals or clinics. Company policy dictates a specific department reaches out to employees to inform them they have been exposed to someone with COVID-19. People now send those calls direct to VM and delete messages without listening because there isn't enough time to do the job and waste time talking to HR.
I don't know being in that position is the result of being reactive and falling behind the curve. Managing the situation has to be better than that.
Nothing to do with being behind the curve. Being behind the curve isn't what caused a state wide medical professional shortage years ago. Hard to be anything but reactive when you are down manpower even before losing your first employee to quarantine or illness.
The variation in healthcare across the state is big but just exacerbates the problem, they are at the forefront, not running the show. Knowing you lack the testing to be conducting contact tracing should have led to more conservative actions, focus the testing at the place's where elderly are confined, close quarter essential manufacturing, before the bloom takes place. It's not like the conditions that made them hot spots just appeared, this is supposed to be in the IDPH purview, it's their responsibility. I can get any reporter to tell me what just happened.
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