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San Mateo County Health Officer Statement on Bay Area Stay-at-Home Orders

322 点作者 EdJiang超过 4 年前

32 条评论

sbuttgereit超过 4 年前
Reading this I was expecting the same knee-jerk, panic response that has become the &quot;acceptable&quot; public health response to the problem the pandemic places before us.<p>While I detect a hint of futility in this statement, I am nonetheless deeply heartened to know some public health officials are themselves questioning some of the simplistic premises that have been driving policy to this point at all levels of government. Really there at least three attributes that I see in this statement that I don&#x27;t typically see in utterings of our bureaucrats:<p>1) I actually get the sense of outright honesty from this statement. Not some overly messsaged, PR driven&#x2F;reviewed statement by some spokes-hole. I actually think this statement is really what this guy believes... a public statement that even expresses some vulnerability. Despite the subject, very refreshing and I&#x27;d be more likely to listen seriously to what he has to say in future.<p>2) Struggling with right and good uses of power and seeing not using one&#x27;s power as itself a public good. Good heavens... this guy should run for President! I expect I&#x27;d disagree with much of his politics, but I&#x27;d vote for him just for having such thoughts and expect the nation would be better off no matter his other leanings.<p>3) Questioning the mandates, their effectiveness, and whether they might be causing more harm than good. And not doing so from some artificial posturing to show &quot;the right politics&quot;, but honest, genuine questioning.<p>Whether you agree or not... I wish more of our public officials were this thoughtful on critical issues such as face us in this pandemic.
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avalys超过 4 年前
Wow. Lest anyone think that Dr. Morrow is some kind of anti-lockdown activist - back in the spring, San Mateo county had one of the most restrictive and prescriptive lockdowns of anywhere in the US (residents were ordered to limit outdoor recreation to within 5 miles of their home).<p>It takes a lot of guts to just look objectively at the data and do what you think is right, regardless of what pressure you’re getting from the media, the state, the governor, your peers in other counties, etc. Not to mention, publicly call out the defects and contradictions in the state level orders. Much respect for this man.<p>&gt; “But what we have before us is a symbolic gesture, it appears to be style over substance, without any hint of enforcement, and I simply don’t believe it will do much good. I think people should stay at home, avoid all non-essential activities, wear masks, and not gather with anyone outside their households. I’ve been saying this for about 10 months now. If you didn’t listen to my (and many others) entreaties before, I don’t think you’ll likely change your behavior based on a new order.”<p>&gt; “Being in the purple tier, the State has already put significant restrictions on businesses and the public space in San Mateo County. I am aware of no data that some of the business activities on which even greater restrictions are being put into place with this new order are the major drivers of transmission. In fact, I think these greater restrictions are likely to drive more activity indoors, a much riskier endeavor. While I don’t have scientific evidence to support this, I also believe these greater restrictions will result in more job loss, more hunger, more despair and desperation (...) and more death from causes other than COVID. And I wonder, are these premature deaths any less worrisome than COVID deaths?”
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ivankirigin超过 4 年前
This is a surprisingly coherent. I live in San Mateo County.<p>One thing I&#x27;ve noticed is that the cases are not evenly distributed.<p><pre><code> California has 600&#x2F;1M new cases, vs 1000&#x2F;M in South Dakota. LA county has 740&#x2F;1M. San Mateo County has 313&#x2F;1M. Within San Mateo County, San Carlos is 119&#x2F;1M, and East Palo Alto is 675&#x2F;1M. </code></pre> It&#x27;s incredibly hard to set policy when everything is so different, down to towns with 30K people a few miles apart.<p>Links:<p><a href="https:&#x2F;&#x2F;covidtracking.com&#x2F;data&#x2F;state&#x2F;south-dakota" rel="nofollow">https:&#x2F;&#x2F;covidtracking.com&#x2F;data&#x2F;state&#x2F;south-dakota</a><p><a href="https:&#x2F;&#x2F;public.tableau.com&#x2F;views&#x2F;COVID-19CasesDashboard_15931020425010&#x2F;Cases?%3Aembed=y&amp;%3AshowVizHome=no" rel="nofollow">https:&#x2F;&#x2F;public.tableau.com&#x2F;views&#x2F;COVID-19CasesDashboard_1593...</a><p><a href="https:&#x2F;&#x2F;www.smchealth.org&#x2F;data-dashboard&#x2F;cases-city" rel="nofollow">https:&#x2F;&#x2F;www.smchealth.org&#x2F;data-dashboard&#x2F;cases-city</a>
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jaspax超过 4 年前
What a delightful thing to read. It&#x27;s so rare in this pandemic to see public health officials actually speaking frankly with a full command of the relevant facts, instead of either rottenly repeating the current consensus or sticking their head in the sand about the whole thing. I especially appreciated his points about &quot;essential businesses&quot; being a totally incoherent category, and his unwillingness to impose restrictions on the entire county based on that arbitrary categorisation.<p>Even aside from his particular recommendations, I can&#x27;t remember the last time I heard a government official talk like an actual human being in this manner. A breath of fresh air.
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acwan93超过 4 年前
This sends a much different and much more coherent message than what I’ve heard in LA County, which makes me believe the Bay Area has this more under control than SoCal even if San Mateo isn’t following in lockstep with the other Bay Area counties.<p>A mix of Mayor Garcetti’s (the city of LA) messaging mixed with the state and county orders, alongside two conflicting health department orders (Pasadena + LA County) have made navigating guidance totally confusing. There’s even infighting within the LA County Board of Supervisors, and talk of some cities to create their own health departments.<p>&gt;14. The new State framework is rife with inexplicable inconsistencies of logic.<p>Not just that, you should read Garcetti’s stay at home orders last week, ordering people to stay home with 12 pages of exceptions.<p>&gt;15. Beyond the basic human needs for air, water, food, shelter, and safety, it has, to date, been impossible for me to define what is “essential” to the 800,000 people who live here.<p>At this point, it seems like it’s up to the business owner to decide if they’re essential. Anecdotally I’ve heard of every small business owner here in LA call themselves essential simply because they “support essential infrastructure”.
sidibe超过 4 年前
I understand the sentiment, but I think it&#x27;s pretty clear in retrospect hard lockdowns were the correct way to address this.<p>This half-assed &quot;wear a mask and social distance if you want&quot; stance just made the economy sputter for a whole a year. I&#x27;ve seen this in France twice, where they&#x27;ve oscillated between doing nothing and doing a lot, a couple brief lockdowns can reverse things quickly even after things have gotten worse than they ever gotten in the USA. In Asia they managed to control the whole thing by trying to squelch it.
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samcheng超过 4 年前
I may not agree with Dr. Morrow, but I definitely salute his willingness to buck consensus. We need civil discourse and robust dissent in our lives, and not in the form of “alternative facts”. I think most of the facts he lists are true, just that his judgements are not quite where mine are.
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threatofrain超过 4 年前
If the sum of regional policies are effective at maneuvering the neighboring counties toward a rate of acceptable and manageable outcomes, then San Mateo is turning the dial in the other direction for the benefit of their businesses and on the backs of surrounding counties.<p>If the consensus of the region is net wrong, then we are irrationally sacrificing our regional economic health, and we are certainly also trading lives in the other direction as well. All policy choices from here have the price of blood.<p>I don&#x27;t accept the position that a policy without robust enforcement is a non-policy, as I think government largely works by a compliant population that trusts their leadership; however, as it becomes increasingly apparent that some wins are purchased by the losses of others, the disparity will brew acute resentment.
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viraptor超过 4 年前
&gt; the structure of our economy is, for the most part, if you don’t work, you don’t eat or have a roof over your head<p>I like that this is raised explicitly. There&#x27;s lots of space for &quot;lockdown with proper support&quot; that the US is extremely unlikely to execute. But I don&#x27;t think it&#x27;s mentioned often enough that that&#x27;s a possible direction.
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Raidion超过 4 年前
As this goes on, I&#x27;m starting to believe that the only way the US (in it&#x27;s current state of cohesion) is to make decisions that are less effective than the &quot;optimal&quot; total lockdown, but are able to get a larger percent of the population acting in better ways. The human brain can&#x27;t function at max threat level over time, and more and more people are chafing at the correct (but impractical and toothless) policies.<p>I feel like those type of good value decisions are hampered by the lack of federal response. A cohesive &quot;wear your mask&quot;, massive PPE manufacturing mobilization, and benefits would have really driven home the seriousness of the situation and provided people the tools to weather the storm. Bars are open because owners don&#x27;t have many other options to support themselves. If the government provided support, that would surely reduce the overall amount of places where masks and social distancing aren&#x27;t enforced, which in turn would allow for better enforcement of existing policies. All this results in a negative feedback cycle where the reduced cases improve contact tracing, reduce waits for tests, etc.
tayo42超过 4 年前
Seems like he&#x27;s being contrarian at times.<p>&gt; what we have before us is a symbolic gesture, it appears to be style over substance<p>I think the problem with being idealistic is people will see this leader,(especially in liberal mecca that is the sf bay area or how ever those people talk now) will latch on to this as a reason to do keep acting irresponsibly and justify their behavior.<p>&gt; Less overall mobility, means less spread. The take home message here is: STOP MOVING!<p>This is why all the counties should act together, otherwise people just go to the open place to do what they want. The adults act like children and need to be treated that way.<p>&gt; I continue to strongly believe our schools need to be open. The adverse effects for some of our kids will likely last for generations.<p>This comes off as dramatic. Like is missing a year of 4th grade going to be a problem for anyone? I barely remember school up until 11th grade at this point. Generations? Why is he saying that?<p>I agree with this though<p>&gt; That the State considers pro sports a critical infrastructure (essential) activity undermines this whole rubric in my mind.
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aazaa超过 4 年前
The article makes some good points about the contradictions in state policy, for example:<p>&gt; That the State considers pro sports a critical infrastructure (essential) activity undermines this whole rubric in my mind. Pro sports is very nice to have and is probably a pleasant distraction. It is not essential. ...<p>This is bad for several reasons:<p>- sporting events involve close contact between participants<p>- sporting events draw crowds<p>- sporting events require infrastructure to service them (restrooms, food, parking, etc)<p>- the blatant contradiction encourages those who have been told to shut down to disobey the order
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sbeller超过 4 年前
Great read. (resident in San Mateo County here)<p>I personally think the whole country should focus more on the greater good for everyone by culling the virus instead of doing this open-nd-close back and forth juggling, as to optimize for the best outcome available (similar to New Zealand). But then again I am not well versed on the Nash equilibrium when it comes to highly infectious diseases.
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mdale超过 4 年前
It falls a bit into the trap of assuming people operate with a level playing field of information though as other mention in thread it&#x27;s deeply refreshing to see a public official act with some humility and respect for it&#x27;s citizens.<p>Issue is we live in times of asymmetrical informational warfare.<p>So we can&#x27;t just provide strong data and recommendations while limiting intervention relative to respecting freedom.<p>Consider how we decreased cigarette smoking via reasonable science driven laws around indoor rules that impact health of others ... and yes graphic commercials of the health consequence which can only be described as full scale information warfare.<p>Would need an accelerated program along these lines to regularly show people suffering in this health crisis to help drive &#x2F; scare people into doing the right thing.
akmodi超过 4 年前
I was searching for research around the infection risk associated with various activities (outdoor vs indoor dining &#x2F; gyms etc). Was hoping to see arguments motivated by contact-tracing data. Wasn&#x27;t able to find much. Did anyone else have better luck?
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heshiebee超过 4 年前
Just alone that the Movie industry in Los Angeles is allowed to continue their operations while small businesses are shut shows exactly what COVID has become. People can make their own decisions whether to go out and how to stay safe.
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standardUser超过 4 年前
&quot;I think people should stay at home, avoid all non-essential activities, wear masks, and not gather with anyone outside their households. I’ve been saying this for about 10 months now. If you didn’t listen to my (and many others) entreaties before, I don’t think you’ll likely change your behavior based on a new order.&quot;<p>Even for the many, many months in many, many parts of the country where case growth was stable and eminently manageable? Wouldn&#x27;t we want to avoid the hardship caused by extreme restrictions when possible? The better approach is to match the level of restrictions with the circumstances within the region, and adjust as needed. Just because most states&#x2F;localities have failed to adjust aggressively enough (or have abdicated responsibility altogether) does not mean they should have simply set a dumb and blind policy of maximum restrictiveness and then sat on their hands, assuming no better way was possible.
lefrenchy超过 4 年前
&gt; What I believed back in May, and what I believe now, is the power and authority to control this pandemic lies primarily in your hands, not mine.<p>So it’s our fault? Some countries succeeded in crushing this virus because of efficient testing and contact tracing, incisive lock downs, and other measures which are put in place by public authority or institutions.<p>What a poor way to deflect blame for the incredibly poor job our government and institutions have done to protect us.<p>Sure, a lot of started from the top down, states need federal funding, and so on and so forth. But to basically tell people they are on their own, is so bad. This is a public health crisis, what authority and power do I honestly have?<p>It’s incredible that our public officials continue to deflect blame to try to distract from how embarrassingly bad our infrastructure was and still is for handling a crisis like this.
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mwexler超过 4 年前
So, this post suggests that lockdowns don&#x27;t &quot;work&quot;: among other things, a lockdown may create reactance causing people to not not only avoid changing their behaviors to reduce risk, it may even make some perform behaviors to increase risk, to themselves and others.<p>It&#x27;s just disappointing that, if true, the opposite doesn&#x27;t work. If only this happened: the gov says &quot;We choose to do no lockdowns, and just have a list of suggestions. No need to follow them. Do your normal activities&quot; and the response: &quot;You can&#x27;t tell me what to do! Screw you! I&#x27;m going to wear masks AND distance, esp among vulnerable populations! Do my normal activities my foot! So there, suck it!&quot;.<p>Reverse psychology always seems to work better in marketing, and low budget movies and sitcoms.
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bosswipe超过 4 年前
Travel is the obvious unaddressed issue in the US. This recent surge started with a big spike in the midwest then slowly spread to the rest of the country. Without interstate travel restrictions these lockdown end up being wasted painful sacrifices by millions of people over many months. No matter how restrictive one region is, they could succefully eradicate the virus, but the virus will just incubate in a less restrictive region and come right back.
gnicholas超过 4 年前
This will provide an interesting experiment since San Mateo County and Santa Clara County are adjacent, demographically similar, and are pursuing different courses of action.<p>But analysis will be complicated by the porous border. There will presumably be even more people coming into SMC from SCC to patronize businesses that are more open than those in SCC.
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dmode超过 4 年前
I agree with San Mateo County&#x27;s stance. I am in Contra Costa and we joined the other counties to shut down at 30% ICU capacity. I don&#x27;t think there is any merit to shutting down outdoor dining. I haven&#x27;t seen any study showing that outdoor dining leads to significant transmission.
asdf333超过 4 年前
kudos on a well reasoned decision.<p>this is all we can expect of our health officers. look at the data and make the best decision possible.<p>if the data changes i hope he will also quickly change his mind
tims33超过 4 年前
It is worth reading many of Dr Morrow&#x27;s previous statements on the pandemic. This statement reflects the learnings across 10 months of fighting this virus. We really do need to some moving, congregating, and gathering in groups indoors. So on some level forcefully shutting everything down should achieve that, but we are humans and will make mistakes. So should we shut our way down into compliance or focus more on the specifics of what science says reduces transmissions? Dr Morrow makes a clear case for the latter. The only trick is how you convince everyone to comply.
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01100011超过 4 年前
I hope when this is all over we can have an apolitcal discussion and learn some lessons for next time.<p>I appreciate the statement, and it&#x27;s nice to see the reasoning of a health official laid bare. That said, it seems to be an inconsistent message and not something I think a health official should be putting out in the midst of a politicized pandemic rife with misinformation.<p>I really wish we had a functioning central government to help coordinate local responses, assist with data collection and monitoring, disseminate clear information, etc, etc.
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troughway超过 4 年前
Whenever I read statements like these I am torn because it&#x27;s difficult to decide whether to cast it aside as &quot;feel good rhetoric, but rhetoric nonetheless&quot; or take it as it is. Do I simply gather the facts and make up my own truth of things, or do I listen to someone pen something like this up where there are so many self-admitted contradictions that you cannot help but wonder if these people are intentionally ruining social order, if they are just that ignorant of their actions.
plasma超过 4 年前
It takes leadership of government, focus, sacrifice, and understanding of the citizens to fight this virus.<p>I&#x27;m based in Australia, Victoria (population of 6m+, exceeding the 800k mentioned in the Bay Area [EDIT: San Mateo county]) and we have now had over 30 days of zero cases of coronavirus, after having a peak of 680+ per day [1].<p>We went into a tough lockdown, stamped out the virus, and are slowly easing restrictions. We are working towards a &quot;COVID normal&quot; holiday season.<p>We had stay at home orders, restricted access to shops (supermarkets remained open but most closed, with one trip per day per household), social distancing orders, and months of wearing masks, and 10-20,000 COVID tests performed per day (again, free).<p>Our Premier Daniel Andrews faced a lot of criticism for pushing this hard, and it was a lot of pressure on small businesses and the mental health of citizens, but ultimately it was the right decision -- the alternative was untenable, let it become out of control and watch our (universal, free) health care become overwhelmed, and no one would even be able to do anything -- an acceptance of the virus flourishing was not acceptable.<p>If you don&#x27;t have a leader capable of fighting this virus, get rid of them. It&#x27;s frustrating and sad watching from afar this virus run amuck in the United States (and the health care system failing you - I&#x27;d _never_ want your insurance system anywhere near me - but that&#x27;s another battle).<p>I hope and wish for the health of everyone affected by this pandemic.<p>[1] <a href="https:&#x2F;&#x2F;www.dhhs.vic.gov.au&#x2F;victorian-coronavirus-covid-19-data" rel="nofollow">https:&#x2F;&#x2F;www.dhhs.vic.gov.au&#x2F;victorian-coronavirus-covid-19-d...</a>
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ajay-b超过 4 年前
Agreed, but what is missing from all of these explanations and defenses is a concrete plan for exiting SAH and lockdown orders. Where does it end, or is it preferable that it never ends?
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russellbeattie超过 4 年前
My fellow humans are idiots. I&#x27;m an idiot. This isn&#x27;t the right way to be a leader. Nuance is not for the masses. They need to be <i>told</i> the right thing to do, especially in a crisis. And then you assume <i>literally everyone</i> will bend the rules as they see fit, because they will.<p>All this long screed does is mess with people&#x27;s heads and cause more problems than it solves. The virus doesn&#x27;t care where the county line is. If everywhere else in the Bay Area is locked down, San Mateo should as well.
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hnrodey超过 4 年前
The article says in San Mateo county there are an estimated 8000-15000 contagious people.<p>That’s several times higher than how many positive test results have been logged in the past 14 days.<p><a href="https:&#x2F;&#x2F;thecovidcomplex.com&#x2F;state&#x2F;california&#x2F;san-mateo&#x2F;summary" rel="nofollow">https:&#x2F;&#x2F;thecovidcomplex.com&#x2F;state&#x2F;california&#x2F;san-mateo&#x2F;summa...</a><p>Disclosure: this is my website based on data from the New York Times.
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jeffbee超过 4 年前
What an incoherent mess. The county should fire this dope. Government health officials need to be out there with a unified message that hits the main points:<p>1) Stay away from other people 2) Wear a mask if forced to go out 3) Go back home as soon as possible<p>This 15-point stream of words will only serve to confuse. The reason our kids are suffering from this year-long school outage is <i>because</i> our leadership is so confused. With unified, clear leadership we would have beat this thing in 6 weeks, tops. It is exactly this framing as a difficult moral wrestling match faced independently by millions of equals that has brought America to this depth of failure.
soupson超过 4 年前
I understand that Dr Morrow is a health professional and not a writing professional. For this reason, I would recommend that San Mateo county hire a public relations &#x2F; social media expert to do some editing on this and future posts. It lacks the structure and coherent message that a public notice needs. I read it from start to finish and I’m not sure exactly what purpose it served beyond Dr. Morrow justifying his decision to the public. Which I’m not sure anyone asked for.<p>I think this could be cut down to a few salient points:<p>(1) Social distancing, mask wearing, and staying at home are the best ways to keep you and others safe.<p>(2) Based on the best available information about hospital capacity, San Mateo is not issuing a Stay at Home order at this time. This means outdoor dining, take out, full capacity grocery remain open at the retailer’s discretion. San Mateo will comply with a Governor’s order if and when that order is issued.<p>(3) Schools will remain open in San Mateo with appropriate sanitation and distancing measures as appropriate.<p>The other 11 points are not needed and should be eliminated. There is also a significant amount of hedging that is not appropriate for a public official &#x2F; medical professional. He’s a leader and an expert, he should state his opinion as one.
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