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Are You Ready for the ‘Socially-Distant Future?’
This afternoon, I was reading my Wall Street Journal from a few days ago (I still take the old-fashioned print edition, and I am always behind), and I noticed more than one article that, taken together, got me to thinking some very uncomfortable thoughts.
I have read more than one article describing the “new office,” brought about by the Wuhan Coronavirus. Most big offices in large cities were shut down by government decree in March and April, resulting in thousands of workers being laid off, furloughed, or directed to work from home to avoid contagion. With some offices now allowed to reopen, companies are having to totally rethink their office layouts, so their employees can be “kept safe.” The bolded chapter heading is “Distancing and Cleanliness.” In the office of the very near future (like tomorrow), “Among the first priorities is figuring out how to maintain social distancing in an office.” Software applications will now govern where and how employees interact. Meetings will be smaller and less frequent, and employee desks will be further apart [thus cutting down on employee interaction]; “density sensors” may prevent too many employees in any one room at a time; all surfaces will be obsessively cleaned all day every day.
In the new office building, elevators will not be allowed to hold more than two people, and all the buttons will either be gone or changed to some kind of “no-touch” technology. Many will still work from home, and their colleagues in the office will hold Zoom meetings when they need to be in a group discussion. A researcher at the Interdisciplinary Center for Healthy Workplaces at UC Berkeley advises “bringing employees together virtually now to share ideas on how to re-establish social bonds while maintaining social distancing.” [italics mine]
Then, there’s the article on the New Hospital. The ideas in that article are extremely depressing to me. The title is “Rethinking the Hospital for the Next Pandemic.” Here are some phrases from that article. What does this make you think?
A future where such crises [the Wuhan Coronavirus Pandemic] may become a grim fact of life.
These changes promise to markedly reduce risk and disease spread-and change the way people experience care even in times when there is no crisis.
…it will also become less hands-on than people have come to expect.
…come up with ways to keep patients out of those [waiting]rooms.
…remotely triaging patients before they even arrive.
…an iPad rigged on a four legged robot called Spot allows staffers to see patients from a safe distance in the ER or a triage tent outside, via a video assessment and a thermal-imaging camera to measure breathing rate.
Keeping Doctors and Patients at a Distance.
To make it safer for patients and staff alike, some hospitals are trying to limit contact.
In intensive-care units, instead of placing IV poles and monitors next to the patient, they are now positioned outside the room so nurses can check patients’ status without unnecessary exposure for both…
For example, he says, newly-diagnosed heart-disease patients, who need frequent checkups and possibly adjustments to their medications, could use the [electronic] system to relay important data to their doctors remotely.
The above observations are scary enough in themselves, but then I was thinking about the “vulnerable elderly” who are confined to nursing homes or live in various other congregate long-term-care environments like assisted-living communities. In the Wuhan Coronavirus pandemic, thousands of such vulnerable elderly people died alone, in their rooms, forbidden to see family and friends in their final days. For some reason, the idea of a video visit on an iPad sounds cold and unfriendly to me.
It is well-known that human beings are social animals. Isolation is used as punishment in prisons and even by mothers with unruly children who send them to their rooms as a “time-out.” It is also well-known that human babies need close contact with their mothers to thrive and grow. Children neglected by their parents and not held or cuddled can waste away, or become depressed or anxious.
The idea of isolation being the theme of the “new office” or the “new hospital” is very unpleasant. It is not a nice thought, that starting now, we need to be afraid of our coworkers, and even our doctors. It is uncomfortable to have to go through life in fear of every other human being you encounter, but it appears that those designing physical spaces, and medical care facilities, will now be doing their best to minimize contact among all employees and clients. It is not fun to think that your hairdresser, your manicurist, and your doctor, are now afraid of you.
I am in the age-group that is now defined as “vulnerable,” and it scares me to think of what it will be like if I ever have to go to a hospital for any reason. Will I be held at arms-length by everyone I encounter? Will I be prevented from having any visitors, including my husband? Will I be forced to suffer, and maybe even die, alone? This is abhorrent to me, and I plan to do everything I can to avoid that kind of future.
I wonder how many others think this kind of future is a nightmare? How many of you out there are horrified with the physical environment that will, by design, keep others away from you? We humans require others around us, for celebrations, concerts, sports, and restaurant meals. Will we all agree to give up things like handshakes when meeting a new colleague, or hugs when comforting a friend who has suffered a loss? I hope and pray that my fellow people will not go happily into the “socially-distant” future without putting up a fight.
Originally posted at RushBabe49.com; visitors always welcome.
Published in Healthcare
So?
There’s no particular rule for interior doors that aren’t “exit” doors, but there’s still common sense.
Yes. The common sense rule is that every room with only one door should have a door swinging out of it, right?
NB: I just realized what the issue is that we are debating. I can’t believe I’m actually in this discussion. It was just started as a joke. I must be very tired and be suffering from impaired judgement. All of us are. ‘Night now, see you in the morning.
Replace depleted uranium tank shells with something biodegradable?
Do research into the formation of black holes?
Seawalls to help with global warming?
The possibilities are endless!
One of Little Miss Anthrope’s doctors is also a deacon at our parish. He prefers the term “physical distancing” to “social distancing.” I find that preferable, too. We require socialization, but there may be times and places where it’s appropriate to be physically distant.
But, even better than a judicious use of terms. . . there is a #resistance movement happening among conservative, small-o orthodox Catholics I know. I’ll be meeting with about 20 ladies and 30 or so of their children for a summer book club at one of the parish school playgrounds tomorrow. No masks anywhere. Many hugs to share. Buncha rebels!
But, also, the same parish is conducting Masses without masks. I find this very hopeful. And, I suspect if any hospitals resist the physical distancing rules, it will be Catholic hospitals. This is both because of the Church’s understanding of human anthropology and even more because the Church is sacramental — meaning we believe God imparts grace to us through physical means as instituted by Christ — laying on of hands, anointing with oils, communion, baptism. . .
I expect, as we learn more about the disease and come up with better treatments, there will be Catholic institutions that defy the most draconian rules and get on with living as human beings.
It is my hope that at least some of the feckless flip-flopping of the CDC was based on efforts to shape exposure to get the most advantage.
But I am often over-optimistic.
New Thunderdome rules.
Every door in my house, including the entry doors in front and in the garage, open into the room, not outward.
That’s true of every door in every house or apartment I’ve ever lived in, and of all the conference rooms in the office where I work.
Wrong kind of stud.
The comedy that could be had during these times, if only we are allowed to laugh at ourselves. The easily offended have pretty much ruined everything.
[In the cold light of day, I still have not come to my senses and withdrawn from this thread-hijacking digression. Here is my reply, given in the hopes that writing it exhausts me, closing one inward-opening door but allowing another, outward-opening one, to open.–MC]
The point about the rule applying only to interior rooms with just one door is that in all others, the term “open into the room” is undefined.
there is plenty of evidence as well as just plain common sense when dealing with respiratory illnesses. Transmission rate is inversely proportional to distance. There is no magic distance-but more than 3 feet dramatically reduces spread. As far back as the Spanish Flu Pandemic (now called the french or Kansas or Lord knows what flu) people wore masks and socially distanced-nothing new.
What do you mean, and what is the relevance of the question to the current political and economic crisis?
An interrobang?
More data on masks:
https://www.forbes.com/sites/alicegwalton/2020/06/13/face-masks-may-be-the-key-determinant-of-the-covid-19-curve-study-suggests/amp/
At the risk of being one more person seeing in the data what I want to see as opposed to what it really means, I am concerned that the logic is “correlation=causation”. That is not scientific proof itself but may be an element of proof. For example there are assertions that an epidemic follows a certain path almost regardless of the strategies employed once community spread has commenced. If true, then the decline during the “mask period” is unsurprising and not linked.
I don’t hold that masks don’t reduce spread at all. But the question is always how much and to what end. There are some people who are compromised with their breathing for whom masks can be problematic. A “no mask, no service” rule excludes these people from service — particularly for any service requiring extended mask wearing. My 90-year old mother-in-law had to sit through 90 continuous minutes of mask wearing to get her hair washed and curled. Next week it will be twice that long with a cut and color. For her it may make sense given her age and risk should she contract the virus. But the reality is that if her hairdresser has the SARS-CoV-2 virus neither the mask the hairdresser wears or the mask my mother-in-law wears will be a sufficient barrier. It might incrementally reduce the number of viral particles but it will not be N95 protection — nowhere near.
My mother-in-law’s attitude is she would like to take her chances without wearing the mask.
But the State of California and Contra Costa County are not giving her a choice. I remain unpersuaded that the efficacy of the mask is so great that it should be mandatory.
The idea that face masks help seems plausible to me, but this study doesn’t provide a lot of support. I guess it’s what we have for now.
I followed the link to this summary of comments on the research. The evidence provided by the study is pretty weak, but it certainly doesn’t contradict the idea that face masks help.
Has anyone here with scientific expertise read this, or seen an objective review of it?
I admit I’ve become a bit skeptical of papers on this subject.
Was this a legitimate study based on proper methodology, or just another junk science hack job in an attempt to give propaganda cover for a prior politically preferred objective?
Yes. Follow the links or use the one I’ve provided. One reviewer changed his (her?) opinion after studying it more closely and decided it wasn’t so worthless, after all. But still, it’s pretty thin gruel.
It’s a retrospective study, and the example locations may have been cherry-picked. (Some of the reviewers hint at that; I’m not sure myself.) A correlation was found between the enactment of face mask legislation and a decline in cumulative case numbers.
Why cumulative case numbers were the variable used is not clear to me. I guess I should read the thing.
From the study:
Yes, but note that the decline brought NYC into correlation with national experience outside of NYC. So the question remains, was Farr’s law at play in NYC or was it masks?
I’ve studied the three figures in the paper, and now I’d say that thin gruel is putting it mildly. They use linear regression to fit trendlines to the daily number of cases for different phases of the epidemic, such as pre-mandatory-facemasks and post-mandatory-facemasks.
Now I see what some of the reviewers mean when they say linear regression isn’t appropriate. Linear regression may work to fit a curve, but tests of significance on auto-correlated data like you’re going to get on a time-series are not valid at all (it would seem to me. Gottta think about this some more, though).
Here is the paper, btw.
The authors really could have benefited from the assistance of a statistician.
It would have been much more informative if NYC had been compared with a number of other localities. The total US data are a mooshing together of the course of the epidemic in a number of different places. In some places the epidemic started early and peaked early, while other locations had yet to experience it. So if you moosh them all together, of course it will look like nothing changed overall.
One problem is that there aren’t a lot of other NYC-sized cities to compare to. Just the same, if the same analysis had been applied to a bunch of cities of various sizes, with and without mandatory masking ordinances, even though the analytical technique is semi-bogus as far as tests of significance go, you would at least have had an N > 1 to look at.
Mrs R and I are planning to go to church tomorrow (most likely) and we will wear our masks even if not everybody else does. But if anybody wants to argue about it, I’m certainly not going to point to that paper as evidence for why everyone else should wear theirs, too.
The PNAS has always been a prestigious journal in my mind, but I’m not up-to-date on which journals have gotten politicized. I do wonder how this paper got past reviewers, though.
Figure 5 is amateurish. It’s a pretty picture, sort of, but doesn’t seem to illustrate anything. It doesn’t clarify anything about the research, and doesn’t even put the research in context. Maybe it would have some use if done as an abstracted timeline. But if anything, the temporal aspects of mitigation measures are muddled on that figure. The reviewers should have caught that and suggested changes.
The conclusions far outrun the data analysis, and are mostly based on other published research. There are public policy prescriptions, which are far from substantiated by any new work contributed by this paper. It’s not even clear if they would be substantiated by the published research that was cited.
There is some discussion of relative humidity and fine particulate matter in the atmosphere in the three study locations (Wuhan, Italy, NYC) and graphs of the values and variation over time, but the purpose for that is unclear. No comparison or contrast is made, either with statistical tests or otherwise. It was odd that this was even included in the paper. Reviewers should have caught that.
Regression lines are run on the cumulative cases vs time. But so what? A “flattening of the curve” is not going to be especially obvious by that method of plotting the data. The lines are said to be linear, but the departures from linearity, which are surely significant and would show up in graphs of daily cases vs time, are ignored.
What would have been interesting is a comparison of cities or other regions, portraying each in the same sort of graph as was used for New York. The statistics would have been bogus, but eyeballing a set of graphs like that could have been informative.
Basically, this was a study with n=1. The 1 was New York City. Other localities had face mask orders, but no comparison was made of localities with and without face mask directives, much less an analysis of compliance.
I see that the main page of the PNAS website has a statement: “PNAS commits to immediately and freely sharing research data and findings relevant to the novel coronavirus (COVID-19) outbreak.”
Maybe that explains how that paper got published. Maybe there was no review process for it.
Moral of the story: If any of you want to buff up your resume with a PNAS paper listing you as first author, now is your chance! Just make sure it’s about coronavirus.