Trump's Plan for Flattening the COVID-19 Curve

At the press conference this afternoon, President Trump and his health advisers announced a 15-day plan to slow the spread of COVID-19. This is the federal government’s latest, and most drastic, plan for flattening the curve of the panepidemic in the U.S. It calls for a 10-person limit on social gatherings, quarantining of members of a household of a person who has tested positive for SARS-Cov-2, and the closing of restaurants, bars, and other places where people gather in states with evidence of community transmission,

"The reason we’re taking these strong and bold steps is because we know there is virus spread before you develop symptoms, and then we know that there’s a large group - we don’t know the precise percent yet - that actually is asymptomatic or has such mild cases that they continue to spread the virus," said Deborah Birx, MD, a top HIV/AIDS official who has emerged as one of the more visible members of the coronavirus task force that Trump assembled and put Vice President MIke Pence in charge of.

The 15-day mark of the guidance should not,though, be mistaken as an estimate for when the tide will be turned on COVID-19 and American returns to the old normal. 

In response to a question today about “how quickly can we turn this corner” [on the COVID-19 epidemic], President Trump said that “it seems to me if we do a really good job….but people are talking about July, August, something like that…”  

You can read the full text of the 15-day plan here. And you can read a transcript of the press conference here.

Here are some of key takeaways from the plan.

Avoid social gatherings in groups of more than 10 people.
Just yesterday the CDC had set the ceiling at 50.

If you feel sick, stay home.
Don’t go to work and contact your medical provider. Plenty of people who aren’t sick with the virus are electing to stay put. The #stayhome hashtag trended on Twitter today. 

If someone in your household has tested positive, then the entire household should stay home.
Extending quarantine to members of an infected person’s household is new. Previous guidance from the CDC advised measures to mitigate the risk of getting infected: stay in another room from the person who had  tested positive, make sure that rooms have good airflow, wash your hands frequently-that kind of thing. Now if one person in the household tests positive, the White House is saying that everyone in that house should stay home, not go to work or school, and someone should contact a medical provider. 

If you are an older person, stay home and away from other people.Older person is not defined in the 15-day guidance, but it is commonly understood that COVID-19 is a much greater health risk for people in their 60s and older.

If you are a person with a serious underlying health condition that can put you at increased risk, stay home and away from other people.
The guidance explains that Increased risk means, for example, having a condition that impairs lung or heart function or one that weakens the immune system. Pregnancy was not mentioned. When a reporter asked about that,  Birx said that data were limited on how harmful COVID-19 might be for pregnant women and their babies.

WFH and “engage in schooling from home” whenever possible.
With VPN and WiFi, office work at home is possible and even preferable for some. Not so service and many other jobs. And the guidelines say that if you work in a “critical infrastructure industry,” such as healthcare services and food supply, “you have a special responsibility to maintain your normal work schedule.” But the guidance also says that “you and your employer should follow CDC guidance to protect your health at work.”

Avoid eating or drinking at bars, restaurants, and food courts and use drive-thru, pickup, or delivery options.
The governor of West Virginia was ridiculed today on Twitter and elsewhere for suggesting that people go to Bob Evans and eat. (The state-by-state case count that the CDC is posting at noon on weekdays shows that as of today, West Virginia is the only state remaining with no cases of COVID-19.)

The fine print (literally) of the White House guidance says that in states with evidence of community transmission of the virus, “bars restaurants, food courts, gyms, and other indoor and outdoor venues where groups of people congregate should be closed.” As of Monday at noon, Washington, California, and New York were the three states the CDC identified as having community transmission.

Close schools in areas with community transmission.
School closing were also discussed in the fine print at the bottom of the second pages of the two-page document. The guidance says that governors of states with community transmission “should close schools in the affected and surrounding areas.”

If there are school closings, states and localities need to address childcare needs of “critical responders” and the nutritional needs of children, the guidance says. Children missing out on school-provided breakfast and lunches has been an issue in some parts of the country.

Avoid discretionary travel, shopping trips, and social visits. 

Do not visit nursing homes or retirement or long-term care facilities “unless to provide critical assistance.

Practice good hygiene.
The guidance repeated the now-familiar advice to wash your hands frequently, avoid touching your face, and sneezing or coughing into a tissue or the inside of your elbow.