Do you have good data on local prevalence rates? I would find that important.

If you decide to have them go in person, maybe make a "red flag" checklist for when they come home, so you will know if your boundaries are not being adhered to despite assurances? Things like indoor gym.

To add to what Moby said, it's not just prevalence rates in the area, but *also* prevalence rates in relevant communities. Here in SF, everybody's really proud that we're getting the case-positivity rate down, but then it turns out that most of the tests are being administered to (drum roll) middle and upper-middle class people. Poor people, and specifically poor Latinx people (also Black people) -- the people who go everywhere in the city and do all the manual labor in all the service businesses -- are undertested, and .... drum roll ... they're coming in at 9% positives. SHRIEK! We find this out b/c UCSF runs some pop-up testing clinics. And they tell the Dept. of Public Health to get a move-on testing in those communities ... to no avail. And gosh, those are the precise communities where people who test positive .... can't quarantine, b/c crowded housing, intergenerational families, and they're *poor* so they gotta work or starve. And the city isn't doing squat about it.

So sure, maybe the test-positivity rate overall is coming down. But since it's not adjusted for population (imagine a telephone poll that doesn't adjust for the actual demographics of the population), it doesn't actually tell you that much about community spread.

9% test-positivity. Shudder.

OK, back to your quandary.

I really feel for you and for all parents, who have to make these decisions. It's really hard, and it's really unfair.

If it were me, I'd keep my kids at home. We're willing to do lots of things, to protect our kids. And this is also about protecting ourselves. Even looking at cost of health care and lost earnings due to getting this bug, if one is unlucky enough to have long-term symptoms, god forbid being crippled, is enough to convince me that for the next six months, I want to do everything I can to protect me and my family from exposure.

I might feel different if I were certain there's no community spread, AND the school was doing proactive surveillance testing (e.g. twice a week, all students and staff).

But can HG&J even keep their kids home? J is himself teaching at school in person, no?

1: The NYT is putting our county at 5.8 per 100L, which makes us light yellow.

I am not sure whether to trust our data or not, though. It's also really hard to get the positivity rate, although one newspaper says our 7 day rolling positivity rate is 23.3%. That's not farfetched for us at all.

It sounds like you're thinking about all the right things and even if you make the wrong decision it won't be too wrong. In five years they probably won't remember it much either way.

4: Jammies will be in-person, yep. A lot will fall to me.

6: Thank you, torque. That's kind of you.

I could give you the links to our online dual Spanish classes but they'd probably notice new kids with Texas accents.

This sounds like such a nightmare, and it's messed up that families have to deal with it.

In your case, I think I'd be particularly concerned about having so many possible household disease vectors in sending them F2F given that there are four Geeblets. I feel as though I'd be iffy on sending one kid to one classroom, and even more nervous sending four kids to four classrooms. Our local YMCA is providing supervision for kids who are doing online school, and something like that in which at least the kids are only exposed to one group of other kids seems like it might be more tolerable, if that's an option. Advice upthread about having defined red flags ahead of time sounds wise.

Wouldn't having that many kids make it easier to send them into work since how can you get anything done otherwise?

When Joey Helpy-Chalk has online P.E., they generally have him go outside and run or bike and they use an phone app to track him. It seems like sensible thing a lot of school districts could do.

I don't have any answers, but every parent I know is dealing with the same struggles. A couple of factors to consider:

1) Is there value in sending them NOW, under the assumption that after the first 9 weeks is over, we may be into another wave of the disease and it will be wiser (or flat-out required) to keep them home in Nov-Dec?

2) Are any of your young people struggling sufficiently with the lack of social interaction that having school would be a net mental health benefit for them even given the increased physical health risk of Covid? [This is what drove one of my sobrinos back to outdoor sports, fyi.]

3) Is it binary? That is, do all four have go or not go? Or is there value in sending the two who most need it, and keeping two home to reduce possible disease vectors?

13.1 is what we figured.

Though the calculation might be different in a state the doesn't have winter.

13.1 was also my sister's calculation. She just sent her two boys (aged 8 and 6) back to F2F school, but anticipates having them back home later in the fall or winter. For the older lad especially, 13.2 also entered into the calculation.

Jammies will be in-person, yep. A lot will fall to me.

And if I were in your position, heebie, I would send them to F2F school, while obviously being vigilant about masks, hand-washing, and etc, and being ready to take them out at the first sign of an uptick in transmission rates.

My kid is going to high school two days a week and the lunch room there is set up as individual desks 6 feet apart and that sounds so sad to me.

You guys, this has been very helpful. And the 23.3% positivity rate that I got from a local paper doesn't seem right - another website is putting it at 4.5%.

Our current plan is to decide to send them back, but not to mention it to the kids, and just sleep on it for a few nights, and see if we feel a growing sense of relief or an awful rock in the pits of our stomach.

This is really dumb, but I feel bad telling the caretaker that we're sending them in and thus don't need her until the shit hits the fan. Or what if she takes some other job and we need her in November??? AUGH

Heebie,

Only you and Jammies can judge what to do. But I feel like I should just note that: it seems a very common story, that schools reopen for f2f teaching, and a few weeks later have to close again. Perhaps you might think about, instead of sending them right away, delaying a month? Let everybody else's kids either behave and not transmit the bug, or transmit it and close down the school? Either way, you should know soon. And you can ask your kids' friends' parents, about whether the school is taking adequate measures, what sort of periodic surveillance testing is in-place, etc.

[yes, I agree this is somewhat selfish; so what, they're *your* kids]

It sounds really tough, and I'm sorry you have to deal with it. I'm sure, regardless of what happens, they will learn lots of useful stuff, so yeah, what torque said.

Also our school district is doing a dismally bad job of planning, preparing, and communicating with parents any sort of plan. It's really been dismaying to see. Their presentations at the school board meetings look bizarrely unprepared. Jammies says they're more prepared than they let on, and they're just too flinchy and defensive to present it to the community out of some self-sabotaging desire to avoid criticism.

I just confirmed with Hawaii's dance teacher and her PE teacher that both will be doing workouts indoors.

WHYYYYYYYY?????????

21 to 22.

I think the real problem is too many kids - too many disease vectors, conflicting schedules, stages of maturity, etc. And of course being in Texas with the right-wing nuts would make it worse. Where I am, mask use could be better but at least businesses take it seriously, and schools are 100 percent virtual until November and even then I think every school is closed Wednesday for cleaning and independent study. I'd suggest moving and leaving a couple kids behind.

Kidding. I actually do think this mess is much harder for you to handle than for my family to handle because of those two factors, but I realize the advice is unhelpful. Sorry, black comedy.

My biggest fear, and I'm not kidding one bit, is that we keep them home all year long, and then get Covid anyway next June.

Just don't sell any watches or hair.

25: My goal is that me, my family and my work colleagues (whose activities I have some influence over) are among the last in the country to get it. By then the doctors will have refined their treatment.

I just confirmed with Hawaii's dance teacher and her PE teacher that both will be doing workouts indoors.

In your climate?! I just don't get this; it doesn't make sense.

I KNOOOOOOW! Everyone here instinctively scoffs at the idea of outdoor education or outdoor sports and explains that it can't be outdoors - it's dance/volleyball/basketball. Why can't 2020-2021 be the year when Texas volleyball is played on the grass?! Is that really utterly ruining anything?!

(besides the grass?)

It's just hard. The Calabat is miserable and learning nothing. But Utah is at 14% positivity and we're not through the worst of it yet so I guess he just doesn't get to have second grade?

Yeah, I missed second grade. That was kinda weird, but it was a weird year a long time ago. I don't remember a whole lot except reading and hanging out in the living room. And the time the dog knocked the vase full of water and flowers into mom's laptop. I remember that really well! And the time dad tried to get me to put mustard on my banana bread, I remember that too! Unless that was third grade. Hm.

I am recognizing now that I have a huge risk-aversion to losing our caretaker. I know I mentioned it upthread, but it's really coming into focus for me.

If we were employing some rando young 20-something to help the kids, I think I'd try sending them in, and then if it didn't work out, we could hire someone else. But I feel so emotionally indebted to this incredible caretaker that I feel like the rug would be pulled out from under me if I took the kids out of school six weeks later, and she wasn't available.

That makes me think I should face up and put my kids back in, while rates are low, and not base their lives on my fears.

But then I remember about Hawaii and the dance class and the PE. And so I continue to go in circles.

We did dancing in squares at school.

If it rained, PE sometimes used a circular parachute to dance with in the gym.

Another consideration is that right now, kids aren't allowed to zoom more than 3 hours per day. In October, when kids go F2F, the at-home kids will have to zoom a lot more. For Hawaii, she'll be zooming for the entire 8-3 pm basically. That's really a depressing amount of zooming.

Last night we gamed out whether or not it would be easy just to yank them out and homeschool the elementary kids, with the caretaker covering the Spanish language aspect. Hawaii would then stay with the remote middle school, despite the awfulness of 8-3 zooms, probably.

I'd think about that as purely a childcare question, and not worry about the academics at all. The year's going to be a mess academically for everyone, they won't fall behind much.

Can you keep having the caretaker if the kids are in school (for after-school hours?), or is that too much cross-exposure risk? If you could do that, then they'd still be with you in six weeks if you need to pull the kids back out.

I'm only thinking about academics insofar as (1) maintaining their Spanish, and (2) not have the experience be pure torture. So we would only consider switching to homeschool if the remote option was pure torture, not because they were or weren't learning anything.

(Now that I'm seeing a lot more of their school day, it really is depressing how bored they are during the vast majority of it because the material is stuff they learned years ago.)

39: Possibly? I'm worried about cross-exposure for her, but maybe she's an adult and can make her own decisions there.... They wouldn't really need her for the 3-5 pm hours, though. They're pretty good at just vegging out and being unsupervised.

Who's the science blogger you all keep recommending for Covid updates? I keep forgetting to bookmark.

Carl Bergstrom? Derek Lowe?

Shaft!

I guess it really doesn't scan.

This one is my favorite. The smart people work with the Johns Hopkins site.

Here's one that, state by state, tries to estimate the rate of transmission so as to give an idea of whether the spread is increasing or decreasing.

Ok, here's a different way of framing this same going-in-circles:

Two camps: (1) Resigned to possibility of getting Covid, or (2) Really trying to avoid it, and just debating the cost that one is willing to incur.

This thread so far has happened inside of the second camp - is the cost of staying home too great? And I think most of us are in the second camp. But it sure would be psychologically easier if I could be in the first camp.

So my question is: is the analysis for avoiding Covid the same as it was back in, say, April? Or now do things look less dire for a couple of 40 year olds who might get it? Ie, how common are the heart damage and lung damage and things like that, in my age group?

A separate question: For viruses in general, how common is a chicken pox -> shingles type of thing? We were reading up on the Chagas virus, which is also a sleeper virus originally and then can cause organ damage ten years later. The 1918 flu later caused Oliver Sacks books. Etc. Is anyone able to extrapolate anything about this kind of danger, for Covid?

The questions in 47 perfectly encapsulate why I am solidly in Camp 2.

47: I don't see 1 and 2 as being contradictory choices. You can be perfectly resigned to the likelihood of getting Covid and still want to do everything possible to not catch it. Even in the worst case scenario, maybe 20% of Americans won't be infected. 1 and 2 don't necessarily imply different choices.

I certainly don't know the answers to your questions. I feel fairly confident that the answers at this point are unclear even to people who know what they are talking about. As Di suggests, uncertainty tends to argue in favor of caution.

Chicken pox - shingles thing only happens with chicken pox and a couple other herpesviruses because they stay latent in a few cells of the body and then reemerge when immunity gets weaker. Chagas disease is caused by a parasite, not a virus and the chronic disease is because the parasites continue to be living in the body long-term (heart muscle cells) causing damage and inflammation. Most things that cause myocarditis (mostly viruses) go away just like lung infections go away, and if there's lasting damage it's because of the damage done during the viral infection (partially damage done by the immune response).

There's no reason to think this virus will stay in the body long-term. Clearly there is lasting damage done in some people who had a severe infection

The sleeping sickness in Awakenings is a weird one. It wasn't actually caused by the flu virus but probably spread because people were susceptible because they were sick with the flu virus. There were similar outbreaks in the past but none since the 1920s.

So the cost of Covid is most likely feeling potentially really sick, but not having any trace of it in, say, a year? What about to the kids?

Is getting Covid going to be a hugely costly pre-existing condition in our new post-ACA healthcare environment? Regardless of the extent of permanent damage?

Clearly there is lasting damage done in some people who had a severe infection

I keep reading stuff that suggests that myocarditis is a problem for folks with mild infections, but I have been skeptical. This piece, for instance, distinguishes between athletes with mild or no symptoms - whose myocarditis was deemed newsworthy this month - and "hospitalized patients," whose problems we have known about for awhile.

47: My thinking, for what it's worth, is that even if it's inevitable that we all get it, it's in my best interest not to be in the group that gets it early on. Survival rates seem to be so much better than they were in March and April just because medical people have figured out better treatments, and it's reasonable to think that we'll get better at treating it as time passes.

Also, one thing to keep in mind is that heart damage, etc., isn't a weird thing unique to COVID. Flu and other viral illness cause the same kinds of problems in some people. I'm not saying, to be clear, that it's just like the flu. But I think a lot of us just didn't really have a sense that the flu we get every year sometimes does a real number on people, and we are now aware of that with COVID, which makes it hard to assess the risks.

Derek Lowe's blog is great to read but is much more about the science of medicine/disease/vaccines but only occasionally touches on the epidemiology or behavioral end of things - you'd want to go elsewhere for that.

My current local community blowup has been over the idea that our city is being too conservative with their criteria for when to exit all-remote schooling and have anyone in person at all. Somerville is being more conservative than (say) Cambridge, next door, and the implication is that the mayor is trying to (a) grandstand about being careful (b) suck up to the teacher's union, which is currently pro-remote in advance of something like running for Governor. And we arguably have a lot of poorer kids who need the in-person support more (and whose parents need the childcare more).

54.1 is sensible and is more or less what I think. It sounds like it can be quite grim to have. Even if you don't end up in hospital (or die) you could have a week or two of really bad flu. I don't want that.
Plus if I do my best to avoid it, I feel better about meeting other people occasionally, because I know the chance I will infect them is very small. I'd rather have paranoia + restricted life + meeting my parents occasionally than resignation + more personal freedom + not seeing my parents.

Heebie, Hawaii's schedule is supposed to be 8-3 every day. But what are they going to do if she only shows up for an hour and then bails on the rest? Expel her? Discipline her? Send you nasty emails? Fail her? Steady is supposed to be going to three forty-five minute blocks but I only make him go to one. Which is painfully boring and I can't believe how slow and dull it is, despite the teacher working her heart out. They spend half an hour on one letter per day. That would have held his interest two years ago. Basically, I'm only having him do enough to count for attendance.

I know that Hawaii is disciplined and will want to do it all, but what if your problem were: what is the absolute minimum they can do to be "in school" (literally, show up for the block that includes attendance) and then "homeschool" or play for the rest of the time? I'm not worried about any formal consequences because really, what are they going to do? This is a pointless year and I'm barely willing to game out school participation for the sake of looking like a good citizen. I sincerely and deeply believe that it will all even out when they return to class after the vaccine.

(I am confident that your kids' play is as much education as they'd get in the lower grades.)

I feel the need to add that in basically endorsing 47(2), that doesn't really offer any kind of guidance for how anyone should actually behave. The question of the costs one is able to bear is entirely a personal one. I mean, yeah, I can't control the schadenfreude I feel when some dumbfuck denialist gets sick and dies. But the disease is mowing down people forced into really difficult situations, or people who are being misled about the risks. We all have to make tough decisions about what risks we can take, or must take.

I suppose this is consistent with my whole COVID approach of 'get the lowest possible passing grade'. Do the literal least to count as 'being in school'. And I'm only doing that because I have the notion that it helps the school.

By "all even out when they return to class" I mean: my kid will be fine.

So, 333 new cases statewide today, on 4300 tests. All time high, beating the record (293) set on Sept 18. 46 of those cases are in Missoula County; we hadn't had 600 altogether up to yesterday, so this is a big jump. This must be why our school board voted on Tuesday to have all students return for 5 days a week, sorry we don't have room for distancing, on November 9. They're decent people, mostly, and the terrible quality of the current education just got to them.

How many of the ton of new cases in the last two weeks are connected to the university somehow?

46 for us is bad. 56 new cases today for Roosevelt County is a catastrophe: population 11,000, over 50% Native.

Rosebud County -- 9,000 people, 30% Native -- 'only' got 16 today. They've had the same number of cases altogether as we have had (our population is 10x) and they've had 6x as many deaths.

50: Ned - Question about chickenpox and shingles vaccines. Why does the CDC recommend you get the Shingrix vaccine at age 50 even if you have received Varivax? Their guidelines say that if you are 50 and found not to be immune, to get the varicella vaccine, but then they still recommend coming back after some interval to get Shingrix? Why? Is it because the vaccine is a live virus?

I ask, because I never had chicken pox. I got vaccinated at some point in my 20's because I didn't get it. Fast forward 10 years, and I got a titre for a job, and there was no varicella antibody. My PCP gave me 2 doses. I was tested again for an unrelated reason, and it showed immunity.

Very much endorse Megan's 58.last.

Heebie, I know this is a huge longshot, but just asking, per this:

But I feel so emotionally indebted to this incredible caretaker that I feel like the rug would be pulled out from under me if I took the kids out of school six weeks later, and she wasn't available.

Is there any possibility you could afford to pay her a six-week 'retainer' to keep her available while you see how things shake out at school?

53: I think there's some evidence maybe that if you exercise vigorously when you have it, you do more damage to the heart. So, in that situation, the fittest among us who are asymptomatic would be most damaged.

52: I watched Fauci get annoyed with Rand Paul yesterday. Murphy's questions followed, and he asked about the myocarditis and suggested just that.

Plus if I do my best to avoid it, I feel better about meeting other people occasionally, because I know the chance I will infect them is very small. I'd rather have paranoia + restricted life + meeting my parents occasionally than resignation + more personal freedom + not seeing my parents.

Just to play devil's advocate, you have all these freedoms even moreso, two months after you've recovered.

Like, if Jammies and I were guaranteed feel like death warmed over for three weeks but nothing beyond that, and the kids just get the sniffles, then let's just let them go to school.

(I don't actually know if I believe this, but I sort of do?)

I think our decision is solely based on longterm damage or future unknowable symptoms? And are those actually pretty unlikely?

The Dakotas are now the two most afflicted states in the country - I fear that may be crossing over to Montana.

Other states seeing spikes now include Wyoming, Idaho, and Utah.

There was a blog post I can't find now that pointed out that while originally COVID transmission was highest in core metro areas, less in suburban, and lowest in rural, they have now equalized. Of course this may be more because the big coastal metros were first hit.

This thread made me go take my temperature (98.6).

69: I think NPR posted a graphic to this effect on Instagram, maybe.

Like where the first 100k deaths came from vs the second 100k deaths.

I think I saw that.

I have no kids, and I don't go out much more than I did during lockdown. Tim has more people at his site than he did before, although now they work shifts, but otherwise there aren't a ton of changes. He was classified as essential.

I'm hoping that a vaccine comes out - even one that makes it more mild, and You can take a test at home, and there's a decent antiviral that your doctor prescribes without your needing to come in. Then I won't mind getting it.

62: Good Lord. Germany has seven times that number of cases today, on 80 times the population.

our decision is solely based on longterm damage or future unknowable symptoms? And are those actually pretty unlikely?

In recent years I've become a lot less sanguine about the long-term health consequences of short-term illness. A few years ago a close friend of mine (young and very healthy (in fact notoriously so, in our friend group, which would mock him for his obsessive exercising and organic kale eating and etc.)) came down with the flu and suddenly died. That was, to put it mildly, a shock. And this February* both M and I caught the flu and it literally took M months to recover. He's always been a generally healthy person and he's only in his 40s, but well into April or May he still had a slight cough and occasional shortness of breath. I really worry about him getting sick again. I used to think, oh, I'm young(ish), I'm healthy, I'll be fine, but not anymore. The human body is resilient, but we're also very fragile.

Anyway, that plus I still want to be able to visit my elderly parents means I am going to try to do what I can to avoid infection for as long as I can. I don't have kids, so that resolution is much easier for me to keep, although it has been getting harder as the world is opening back up.

*Of course we kinda sorta think it might have been covid-19, but it was the second week of February, so probably still too early in the timeline, and anyway, we still have no real idea of how well the human immune system protects from reinfection.

69 Roosevelt County borders ND. I'd also expect there to be a lot of familial relationships between folks living on the Ft Peck rez (Dakota and Assiniboine) and the Dakota nations in the Dakotas. I don't have that same sense for the Cheyenne community in Rosebud, but Lame Deer is on the road from Billings to Spearfish, so there's that. The Cheyenne cases are more likely more closely connected to Billings and the Crow Nation though.

71: I found it.

Anyway, it's a very good presentation of the data, so it stuck in my mind. But it wasn't easy to find the right search term.

So, I have a fever, like 100.5. I am feeling a bit off, but not bad ill. Just tired, but I am was not surprised I'm tired. I ran two miles, then ate half a chicken, then had five beers and watched the Columbo episode where (Spoiler Alert) Jack Cassidy was the murderer. Anyway, do beers raise your skin temperature. I was using the forehead thermometer.

I guess I ordered half a chicken, but these days I don't eat fast enough to get all of my food before it is stolen.

And french fries. I also had fries. And I would eat more fries if I had them.

Now my fever is gone. I don't know what's up.

Maybe wait 15 minutes after a beer before taking your temperature?

Five beers would definitely raise my skin temperature and produce additional symptoms of serious illness. I'm sure you're fine.

My daughter and I briefly went shopping in a somewhat crowded Target this week, and I'm just waiting to die now. Mild headaches induce all sorts of theatrics. Take care of yourselves and your livers, everyone.

watched the Columbo episode where (Spoiler Alert) Jack Cassidy was the murderer

The one where he's a mystery writer, or the one where he's a mystery publisher, or the one where he's a mystery stage magician?

My main achievement in the lockdown era has been watching lots of Columbo.

I'm long overdue for a rewatch. I do a good Peter Falk impression.

86: Publisher.

No fever.