[avalys]

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).

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.

> “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.”

> “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?”

[adinosaur123]

> "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?”

There's been a total of 164 registered COVID-19 related deaths in San Francisco county, the vast majority of which had other comorbidities, assuming trend[1]. On the other hand, there has been nearly three times (~460) as many deaths in San Francisco related to overdoses between January and August alone[2].

It's hard to disagree with his sentiment.

[1]: https://www.cdc.gov/nchs/nvss/vsrr/covid_weekly/index.htm#Co...

[2]: https://www.sfchronicle.com/projects/2020/sf-overdoses-inter...

[jacobolus]

San Francisco has so far had by far the best Covid health outcomes of any major US city. If the US on the whole were doing as well as SF, there would be at least 200,000 fewer deaths than there have been.

I really hope SF can keep it that way. The recent trend is pretty scary, but if we all hunker down for the next month or two, we can still turn it around.

[sokoloff]

SF has had 30% of the deaths per 100K as the US average? That is shockingly good and worthy of deeper study if true.

[jacobolus]

Less than that. SF has had about 20.5 confirmed Covid deaths / 100k so far.

The USA overall has had about 86 confirmed Covid deaths / 100k.

And the USA total is likely a more significant underestimate than the SF total, as there are many places where there has been an abnormal spike of “pneumonia”, “stroke”, etc. deaths never attributed to Covid.

[Chris2048]

Does SF has similar age demographics to the rest of the US?

[mattigames]

I disagree: overdoses in 2018 killed 259, in 2019 it killed 441, so I don't think it was really surprising to get around 550 for this year.

[bpodgursky]

Do you... expect drug overdose deaths to increase exponentially, as standard practice?

[mattigames]

No, but if they increased 80% in one year is not that strange if the next one they increase around 40%

[shostack]

Not only did it have one of the most aggressive and immediate responses to the issue, but for a long time we were relatively sheltered as the virus raged across the nation because these measures were highly effective, and people to a large degree listened.

He has been a straight shooter from the get go, including a while back when he said the State's orders didn't make sense because they were all or nothing for opening up and he felt that many indoor spaces were not safe to reopen.

Unfortunately, it seems much of his frustration stems from the fact that humans suck at nuance with things like this but are absolutely amazing at rationalizing anything.

I wish I knew who he was referring to specifically when he says things like:

"I may have a different view of the power and authority I have, as a function of my position, than some of my colleagues."

If they are elected, I want them out.

Ultimately, it is disheartening that the people who need to hear his message the most will not read his post.

[WalterGR]

”I may have a different view of the power and authority I have, as a function of my position, than some of my colleagues."

Maybe some of his colleagues believe that sheriffs report through the Attorney General, as per the California constitution.

If they are elected, I want them out.

[mehrdadn]

> I am aware of no data that some of the business activities [...] are the major drivers of transmission

This suggests he is aware of data indicating that some of the business activities being restricted drive transmission, just not all of them. (I'm guessing maybe, say, indoor dining?) So should those known to do this be restricted or not? Did restricting them previously help or not? Should we ignore them?

[chipotle_coyote]

It seems to be fairly well established at this point that poor ventilation is an issue; spending time around others who may be carrying the virus is an issue; wearing a mask, whether inside or outside, significantly reduces the chance of spreading the virus if you're a carrier. So your guess seems pretty on point. Indoor dining/drinking means being around others without masks in areas where air is circulated rather than fully exchanged, so it's about as risky as you can get short of a church service or choir practice (which has all of those risks but adds "let's project particles from deep in our lungs while singing"). "Spreading events" under those conditions have been pretty well-documented, as far as I know.

So, I'd say Dr. Morrow is aware that some of the restricted business activities drive transmission and he's supporting those restrictions. There are other activities -- like outdoor dining, as long as you're not putting diners in circulation-restricting tents -- that seem to be lower risk, and could probably further mitigate risks by having limitations on group size, dining time, etc., rather than just a point-blank ban. And there are some other restrictions which just seem more like theatre, such as curfews. Do we think coronavirus is nocturnal?

> Should we ignore them, then?

I'm not sure how useful that question is for folks who don't run businesses facing that decision. If I was a restaurant operator, I wouldn't flagrantly flout the local regulations even if I disagreed with them. I'm not, though, and the restrictions that more directly apply to me as a citizen -- e.g., try to stay at home during this surge, don't gather in groups even with folks in your "quarantine bubble" -- don't seem that wildly unreasonable.

[wwweston]

> And there are some other restrictions which just seem more like theatre, such as curfews. Do we think coronavirus is nocturnal?

The way I've heard some people explain it is that human behavior changes nocturnaly. After 10pm what are most people doing out? Nightlife and drinking overlap pretty heavily, social drinking and social distancing are kindof contradictory, and alcohol isn't known for increasing people's capacity for conscientious observance of safety practices.

[tshaddox]

Or, even simpler: less time in the day for interactions means less interaction.

[bsder]

> as long as you're not putting diners in circulation-restricting tents

The problem is that this is EXACTLY what they are doing.

One mexican restaurant near me has a nice parking lot that they converted to outdoor dining. Yes!

And then put a tent up with heaters under it because it got "cold". ARRRRGH!!!!!!

[ketzo]

As long as it’s an actual tent, with open sides, it’s a pretty huge improvement. I don’t have the link, but I read that basically anything outdoors with open sides might as well be totally outdoors, since the heat created in the tent will naturally cause the air to be exchanged constantly (plus, obviously, the breeze).

[chipotle_coyote]

Oh, sure, I've seen it too, which is why I had to add that caveat. "Yes, outdoor dining is much safer!" "..uh, maybe not like that."

[gnopgnip]

A significant number of people are going to restaurants outdoors with other people from outside their household. This is more common after 10pm. So in a vacuum these activities could be done safely, but in practice they contribute to the spread of covid

[sp332]

It's supposed to be supported isolation. Gotta make sure people can make rent and eat and otherwise stay alive, or they're not going to stay home.

[orangecat]

Gotta make sure people can make rent and eat and otherwise stay alive, or they're not going to stay home.

Even ignoring financial considerations, expecting people to have no in-person contact with anyone outside their homes for 9+ months is utterly unrealistic.

[WalterGR]

Literally no one is expecting that, let alone suggesting it.

[daveFNbuck]

I live in San Mateo county, and am interested in knowing what to do to stay safe. This is the first I've heard about limiting outdoor recreation to within 5 miles of my home.

I haven't been notified about any of the details of any of the lockdowns. In the Spring, I encountered a group of people who had just been released from jail during one of my monthly shopping trips. Despite having just been in government custody, they didn't even know the basics about things like social distancing, much less any more specific restrictions.

How are these things supposed to be effective when it's so hard to learn about them?

[shostack]

What have you tried to stay notified about details? the SMCAlert system texts and emails me links to details as soon as any changes occur. It has been fantastic for this and other situations.

https://hsd.smcsheriff.com/smcalert

[daveFNbuck]

I tried a lot. I spent a good amount of time searching for what the restrictions were in my city. I found news articles describing restrictions, but I wasn't able to locate primary sources or a way to keep updated.

Even with the link you sent me, that site gives no indication that it's a way to get updates on pandemic-related news and restrictions. It seems to just be an emergency subscription. What other messages does it send that aren't described in the FAQs?

[babesh]

https://www.smchealth.org/coronavirus

This is directly from the horse’s mouth. This is San Mateo County’s health website.

Also Nextdoor.

Also if you subscribe to emails from your city.

Also the local news.

[daveFNbuck]

My wife just alerted me to new restrictions she heard about on Twitter. I went to https://www.smchealth.org/coronavirus to read more about it, and I don't see anything different from when you linked me to it 10 days ago.

[jeffbee]

You're confused because the county health information system is being mismanaged and misused as a blog by a crank. He doesn't allow anyone to send public information on his behalf and he requires all of his writings to be distributed verbatim[1]. That's why they all read like incoherent rambles. It's also why every one of his messages begins with the instructions to "reread my previous statements below", because he's top-quoting himself in Outlook! He just does not understand the impact his intentional aversion to clarity is having on the region.

1: https://www.nytimes.com/2020/03/12/us/coronavirus-san-mateo-...

[x3n0ph3n3]

I think you confuse clarity with oversimplification. Nothing he's written so far makes him sound like a crank.

[rriepe]

> some kind of anti-lockdown activist

Gasp!

[olliej]

Well, it's been demonstrated around the country that not locking down is considered perfectly acceptable.

The reason for the lock down is to prevent numbers from skyrocketing - the anemic response from the US ensures long term economic damage due to failure to control the outbreak - the question becomes one of what the numbers in Sean Mateo will do over the next few weeks compared to the surrounding cities. Ignoring of course infections spread to the surrounding areas by San Mateo remaining open.