COVID-19: Coronavirus June 2020

Roxxsmom

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Starting out the new month with a question. Why do the daily new case counts vary so much on both national and state levels. I'd expect some variation, given the nature of things, but how is it possible to fluctuate between less than 5k new cases on one day (and in some states the number is as low as zero) to over thirty thousand nationwide the next? The image linked below shows what I mean.

https://infection2020.com/?r=1

You have to click the overall case numbers off to increase the resolution on new case numbers over time.

I assume some days, like Sundays, offices are closed and fewer cases are reported, but my understanding is that after they start analyzing the data, they "backfill" the dates to when they were actually tested, not the date the test results came in. Testing centers, urgent care centers, and ERs are open 7 days, aren't they?

In any case, it would be more useful to analyze the data and present them as averages over several days. That makes for more meaningful comparisons of new case numbers over time.
 
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cbenoi1

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Two sentences I read today on a Facebook forum that had my stomach tied in knots all day.

"I realized I had lost my sense of taste this morning. Wish me luck."

-cb
 

MaeZe

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Not a fat chance. Facebook doesn't transmit viruses - well, not of THIS type anyway.

-cb
So you most likely don't have it.

Some one on another forum lost his taste, it came back in a couple days and his COVID 19 test was negative. He never developed a fever. No clue what it's about.

My autoimmune disease wiped out my tastebuds (they come back quickly) but my whole mouth was inflamed with the tongue and no one else has my odd variety of autoimmune symptoms. So probably not helpful.
 

MaeZe

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Well this sucks:

Surgisphere: governments and WHO changed Covid-19 policy based on suspect data from tiny US company
Surgisphere, whose employees appear to include a sci-fi writer and adult content model, provided database behind Lancet and New England Journal of Medicine hydroxychloroquine studies...

The Guardian’s investigation has found:

A search of publicly available material suggests several of Surgisphere’s employees have little or no data or scientific background. An employee listed as a science editor appears to be a science fiction author and fantasy artist. Another employee listed as a marketing executive is an adult model and events hostess.
The company’s LinkedIn page has fewer than 100 followers and last week listed just six employees. This was changed to three employees as of Wednesday.
While Surgisphere claims to run one of the largest and fastest hospital databases in the world, it has almost no online presence. Its Twitter handle has fewer than 170 followers, with no posts between October 2017 and March 2020.
Until Monday, the “get in touch” link on Surgisphere’s homepage redirected to a WordPress template for a cryptocurrency website, raising questions about how hospitals could easily contact the company to join its database.
Desai has been named in three medical malpractice suits, unrelated to the Surgisphere database. In an interview with the Scientist, Desai previously described the allegations as “unfounded”.
In 2008, Desai launched a crowdfunding campaign on the website Indiegogo promoting a wearable “next generation human augmentation device that can help you achieve what you never thought was possible”. The device never came to fruition.
Desai’s Wikipedia page has been deleted following questions about Surgisphere and his history, first raised in 2010....

Another study using the Surgisphere database, again co-authored by Desai, found the anti-parasite drug ivermectin reduced death rates in severely ill Covid-19 patients. It was published online in the Social Science Research Network e-library, before peer-review or publication in a medical journal, and prompted the Peruvian government to add ivermectin to its national Covid-19 therapeutic guidelines.

The New England Journal of Medicine also published a peer-reviewed Desai study based on Surgisphere data, which included data from Covid-19 patients from 169 hospitals in 11 countries in Asia, Europe and North America. It found common heart medications known as angiotensin-converting–enzyme inhibitors and angiotensin-receptor blockers were not associated with a higher risk of harm in Covid-19

That is a lot of fake research that clinical decisions were based on.

Surgisphere ‘came out of nowhere’
One of the questions that has most baffled the scientific community is how Surgisphere, established by Desai in 2008 as a medical education company that published textbooks, became the owner of a powerful international database. That database, despite only being announced by Surgisphere recently, boasts access to data from 96,000 patients in 1,200 hospitals around the world.

When contacted by the Guardian, Desai said his company employed just 11 people. The employees listed on LinkedIn were recorded on the site as having joined Surgisphere only two months ago. Several did not appear to have a scientific or statistical background, but mention expertise in strategy, copywriting, leadership and acquisition.

Dr James Todaro, who runs MedicineUncensored, a website that publishes the results of hydroxychloroquine studies, said: “Surgisphere came out of nowhere to conduct perhaps the most influential global study in this pandemic in the matter of a few weeks.

“It doesn’t make sense,” he said. “It would require many more researchers than it claims to have for this expedient and [size] of multinational study to be possible.”

- - - Updated - - -

Well this sucks:

Surgisphere: governments and WHO changed Covid-19 policy based on suspect data from tiny US company
Surgisphere, whose employees appear to include a sci-fi writer and adult content model, provided database behind Lancet and New England Journal of Medicine hydroxychloroquine studies...

The Guardian’s investigation has found:

A search of publicly available material suggests several of Surgisphere’s employees have little or no data or scientific background. An employee listed as a science editor appears to be a science fiction author and fantasy artist. Another employee listed as a marketing executive is an adult model and events hostess.
The company’s LinkedIn page has fewer than 100 followers and last week listed just six employees. This was changed to three employees as of Wednesday.
While Surgisphere claims to run one of the largest and fastest hospital databases in the world, it has almost no online presence. Its Twitter handle has fewer than 170 followers, with no posts between October 2017 and March 2020.
Until Monday, the “get in touch” link on Surgisphere’s homepage redirected to a WordPress template for a cryptocurrency website, raising questions about how hospitals could easily contact the company to join its database.
Desai has been named in three medical malpractice suits, unrelated to the Surgisphere database. In an interview with the Scientist, Desai previously described the allegations as “unfounded”.
In 2008, Desai launched a crowdfunding campaign on the website Indiegogo promoting a wearable “next generation human augmentation device that can help you achieve what you never thought was possible”. The device never came to fruition.
Desai’s Wikipedia page has been deleted following questions about Surgisphere and his history, first raised in 2010....

Another study using the Surgisphere database, again co-authored by Desai, found the anti-parasite drug ivermectin reduced death rates in severely ill Covid-19 patients. It was published online in the Social Science Research Network e-library, before peer-review or publication in a medical journal, and prompted the Peruvian government to add ivermectin to its national Covid-19 therapeutic guidelines.

The New England Journal of Medicine also published a peer-reviewed Desai study based on Surgisphere data, which included data from Covid-19 patients from 169 hospitals in 11 countries in Asia, Europe and North America. It found common heart medications known as angiotensin-converting–enzyme inhibitors and angiotensin-receptor blockers were not associated with a higher risk of harm in Covid-19

That is a lot of fake research that clinical decisions were based on.

Surgisphere ‘came out of nowhere’
One of the questions that has most baffled the scientific community is how Surgisphere, established by Desai in 2008 as a medical education company that published textbooks, became the owner of a powerful international database. That database, despite only being announced by Surgisphere recently, boasts access to data from 96,000 patients in 1,200 hospitals around the world.

When contacted by the Guardian, Desai said his company employed just 11 people. The employees listed on LinkedIn were recorded on the site as having joined Surgisphere only two months ago. Several did not appear to have a scientific or statistical background, but mention expertise in strategy, copywriting, leadership and acquisition.

Dr James Todaro, who runs MedicineUncensored, a website that publishes the results of hydroxychloroquine studies, said: “Surgisphere came out of nowhere to conduct perhaps the most influential global study in this pandemic in the matter of a few weeks.

“It doesn’t make sense,” he said. “It would require many more researchers than it claims to have for this expedient and [size] of multinational study to be possible.”
 

Roxxsmom

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That's stunning!

Yes, and it really makes me think about how the conversation about this virus has shifted over time. Early on, there were many editorials, even from people with knowledge of public health and epidemiology, who were insisting it was no worse than the flu, and they pointed to the fact that we lose tens of thousands of people to flu in a typical year without shutting everything down.

Then, when it became clear that this virus follows a different course than the flu, and requires much higher rates of ventilation and longer hospital stays than influenza for the sickest patients to have a chance at recovery, people started "reminding" us how many more people still die of other things, from cancer to malaria, and how we're just afraid of the unknown blah, blah, blah.

Well, being afraid of a new, unknown disease makes perfect sense, because there is still a lot we don't know about the different ways it affects us and the true case and infection mortality rates. But aside from that, people willfully ignored that these deaths were in addition to the other things people die of, not instead of. All of this while the death toll continued to mount.

Now it seems people have moved on to acceptance. Hospitalizations and deaths are increasing again in many places, including parts of my own state, and many cases are now linked to large gatherings. But no one seems to care anymore. Fewer people are wearing masks, and even health care environments have given up on nagging people about them.

I think once people realized that a disproportionate number of deaths are among the elderly, and people in nursing homes, and in poorer communities of color, then they breathed a sigh of relief and decided there was no significant risk at all to "people like them."
 
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MaeZe

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Yesterday I heard the ignorant argument that more people are killed by cancer and we don't shut the economy down.

No clue why we are in a lock down, none.

There will be several models, sadly, as to what happens to the economies of countries that don't lock down at all. Sweden is sort of a half-way case. People are trying to self isolate but schools are open. Cases have risen dramatically compared to similar countries. Yet the economy in Sweden is not faring much better at all. There appears to be little to no benefit in not locking the economy down.

My prediction is that even if you don't close schools and businesses down, absenteeism will have a great impact on the economy along with the overwhelming of medical systems. It will take a bit more time to see the effects of the pandemic where it isn't controlled.

And in places like Brazil, one can't help but think Bolsonaro would like to see the favelas depopulated.
 

jennontheisland

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Some of the wonkiness in numbers may come from recorded cause of death. Earliest reports of the collection of symptoms called it a virus-induced pneumonia (I can't seem to find the WHO report I read back in Jan, but I believe it used NCIP - novel coronavirus induced pneumonia) and it seems that some states are reporting significantly more deaths due to pneumonia lately.

https://www.emptywheel.net/2020/05/...-this-season-than-average-over-previous-five/

https://twitter.com/SquireForYou/status/1265553065056362497
 

AW Admin

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You don't lose 100,000 people to cancer in the U.S. in four months from February - May.
 

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I think the differing numbers come from the fact that reporting methods (or non-methods) vary so widely, even from town to town in the same state. At any rate, it's really sad to see the number of new cases rising again. Which raises a question: Has anyone out there discovered a way to convince covid-19 deniers that, yes, it really is a pandemic? (That's kind of a loaded question because I just watched a Neil deGrass Tyson lecture where he addressed the nature of belief. One of his conclusions seemed to be that, once a person has latched onto a belief, it's almost impossible to change their minds. That's just the nature of humanity, he says, which makes me want to howl.)
 

MaeZe

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Maybe posted already, I didn't see it.

Yahoo News: WHO walks back statement on 'very rare' asymptomatic spread as infectious disease experts say it is 'not accurate'
The World Health Organization is walking back a statement made by Dr. Maria Van Kerkhove, an infectious disease specialist and the organization’s COVID-19 technical lead, which sparked confusion about how the coronavirus spreads. Van Kerkhove, in a video widely shared on social media, on Monday described the asymptomatic transmission of the virus as “very rare.”

After epidemiologists pushed back on the claim — including the former director of the Centers for Disease Control and Prevention Thomas Frieden — WHO hosted a Q&A on Tuesday morning in which Van Kerkhove clarified the statement. “I was responding to a question at the press conference. I wasn’t stating a policy of WHO or anything like that,” she told reporters. “I used the phrase ‘very rare,’ and I think that that’s [a] misunderstanding to state that asymptomatic transmission globally is very rare. I was referring to a small subset of studies.”

Ironic to see the CDC complaining when I was saying the same thing to their assertion of no asymptomatic spread when they were towing Trump's line.

Van Kerkhove went on to note that asymptomatic spread could range from 6 percent to 41 percent, based on the preliminary studies, but that more studies are needed. While the correction has been well received, epidemiologists are still unpacking what led to the claim. Dr. William Schaffner, an infectious disease expert at Vanderbilt University School of Medicine, says that the statement left epidemiologists “scratching their heads” afterward. “We were all confused,” says Schaffner. “What’s clear is that they’ve made things less clear.”
 
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CWatts

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A previously healthy woman in her 20s has had a double lung transplant due to COVID-19 destroying her lung tissue.

https://www.nm.org/about-us/northwe...-on-covid-19-patient-at-northwestern-medicine

However, during her stay in the COVID ICU at Northwestern Memorial Hospital, while her body cleared the virus, her lungs were damaged beyond repair.

“How did a healthy woman in her 20s get to this point? There’s still so much we have yet to learn about COVID-19. Why are some cases worse than others? The multidisciplinary research team at Northwestern Medicine is trying to find out,” says Rade Tomic, MD, a pulmonologist and medical director of the Lung Transplant Program.


“COVID-19 results in significant damage to the lungs of patients were severe disease,” adds Michael Ison, MD, infectious diseases and organ transplantation specialist at Northwestern Medicine. “Opening the door to patients who have recovered from the infection to lung transplantation offers a potential path to recovery.”
 

Stytch

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I think the differing numbers come from the fact that reporting methods (or non-methods) vary so widely, even from town to town in the same state. At any rate, it's really sad to see the number of new cases rising again. Which raises a question: Has anyone out there discovered a way to convince covid-19 deniers that, yes, it really is a pandemic? (That's kind of a loaded question because I just watched a Neil deGrass Tyson lecture where he addressed the nature of belief. One of his conclusions seemed to be that, once a person has latched onto a belief, it's almost impossible to change their minds. That's just the nature of humanity, he says, which makes me want to howl.)

I've got a FB friend who just continues to call all this an over-hyped nothing. He's not full-on "it's a hoax" but he definitely refuses to believe it's anything anyone should worry about, and that all the Democratic governors are lying to inflate their numbers, etc. I showed him the CDC's chart that shows the big increase in OVERALL deaths (not broken down by cause, it just shows that a lot more people are dying than normal) and he was like "well, those are just the people that would have died of the flu in the winter, and they're dying now." And then he talked about how "the CDC makes its living off scaring people and they have missed their own predictions by millions."

Some people you just can't help.

In personal CV19 news, I have a cousin whose family tested positive, (her, hubs, and their little girl) and recovered seemingly OK minus a few rough days. As soon as she and the girl tested negative she jumped in to donate plasma. The hubs didn't bother to get tested again, for whatever reasons of his own. (That's not the interesting part, though I am thankful for their health.) So, get this ... she lives several states away, and I haven't physically seen her in maybe a decade. BUT, last weekend, which was just a couple of days after her negative results, my family was coming back from our weekly inspection visit to our house (under construction, so we go once a week and see what's been done, and the site is empty and back up in a field) and who do I see as we pull into the gas station?? My cousin!!! We stop the car and I jump out to say hi and hug this member of my family that I haven't seen in forever. She said I was the first person she'd hugged outside of her immediate family in months, let alone touched. It was one of those "holy cow, what a coincidence" moments. Like, I never leave my house now, except for this one weekly trip and maybe the grocery store. (Sometimes he goes instead.) They had just hopped off the interstate for gas, on their way to somewhere else. Now, my town is right on I-95, so if I knew about all the friends and family that drove right through my town without telling me, I'd probably be very amused, but that's not the point here. No judgement that they didn't call or anything. Anyhow, I knew about her negative test before I hugged her, but I can't stop the worrying thought that I did something stupid, even though it felt like God was like, "Hey, here's your cousin since you need something nice for a change." I guess I'll know in another week or so. We stood outside in the gas station parking lot talking for maybe 15 minutes, not too long, and I kept the kids in the car so they only talked through the rolled down window. Afterwards we went right home and everyone washed their hands, etc. Since then, we all continue to be fine, if forgetting what the old routines looked like. I feel like we're all just doing the best we can, picking and choosing as few risks as possible while still trying to be a little bit normal.
 

Roxxsmom

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Well, cases are increasing in our county again, hospitalizations are up, but they're still opening bars, gyms and theaters as of midnight tonight.

https://www.sacbee.com/news/coronavirus/article243486491.html

LA, whose cases are also increasing, is keeping bars and movie theaters closed for the time being.

Bars seem like they should be one of the last things they open. 1. They are not necessary for daily life by any stretch of the imagination. 2. You cannot drink with a mask on. 3. When people are drunk, they're going to get really stupid about social distancing and personal hygiene.

I am rather baffled as to the phase 3 opening priorities. So many outdoor activities have stayed closed until phase 3, even though they seem to be far less risky. People still aren't supposed to play, say, basketball at the park, because of incidental close contact, and children's playgrounds remain closed. How many cases have been contact traced to outdoor basketball between friends or kids on playgrounds? We are opening gyms, where people will be breathing hard, likely not all will be masked, and ventilation may or may not be great.

I need to start exercising again, but I don't think I'd feel terribly safe at the gym.

And they are opening bars--adult playgrounds where a drug that lowers people's inhibitions and good judgment is consumed in quantity.

Since evidence is mounting that mask use really does reduce the spread of the virus, indoor activities where people will be in prolonged contact and masks can't be worn (such as indoor bars, gyms, and restaurants), seem like the last places that should open.
 
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Roxxsmom

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That statement by the WHO made no sense at all. If the risk of asymptomatic spread in the community is very low, then what would be the point of all the social distancing they recommended? Why are epidemiologists (including the WHO) been telling us how many lives social distancing has saved? Not to mention studies telling us how many more could have been saved had we locked down even a few days earlier? And why are case numbers rising in many places, linked to gatherings at church, birthday partiesetc? I can't believe many people would be attending birthday parties etc. if they have covid-19 symptoms.

It's possible they have a different definition of the phrase "very rare" than many of us do. To me, "very rare" would be less than 1% of cases. Maybe they mean it's "only" about 10% or so of the total transmission. I'm just guessing, though. Vague words like "rare" and "a few" and so on don't mean the same thing to everyone (I had a mild spat, if you want to call it that, with my spouse over the meaning of "a few" just the other day. He said two could be "a few," and I said no, because two="a couple," but I digress.

Regardless, even a relatively low percentage of cases spread in the community via asymptomatic carriers could add up to a big number if those people bring the disease home to their families or their co-workers etc. and anyway, maybe the rarity of spread by asymptomatic carriers since the "early data" they talked about in the report is precisely because people have been socially distancing when they can. If people are spending most of their time in the company of household members and coworkers, then that's who most will be getting the disease from--not out in the community.

Or am I missing something here?

It also illustrates an issue that has frustrated me since the very beginning of this pandemic--imprecise terms and phrasing by people who should know better. I understand why journalists and laypeople are often vague and imprecise and inconsistent in their descriptions and usage, but infectious disease experts need to be very clear about what they mean when they say things like this. If they don't have a hard number, or even a rough estimate, then they need to say so.

All along, that has been the hardest thing about this virus for everyone--all the unknowns. I get that, but it's better to admit what you don't know than to feign certainty you don't have. People misinterpret vaguely worded descriptions, and they lose faith in the experts, and that only makes things worse.
 

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I'm shocked by the behaviour of a lot of people in the places where the virus is the worst. It's like it never even happened. I do wonder if the media is complicit to an extent. They can't focus on more than one story for a few weeks.

Here in Australia we're in such a weird situation. The only case in my territory in a very, very long time - we've had only two cases in months - was a diplomat who arrived from overseas and is now in isolation. Our silly government decided that diplomats don't have to go into mandatory, police-guarded hotel quarantine like everyone else in Australia does when they arrive in the country, and because I live in the capital city we get all of them. And all the interstate politicians who refuse to follow the rules. :rolleyes:

I'd almost forgotten about the virus here, but then I went to the library, where they're pretty much taking it more seriously than anyone else in the world. Capacity limits. Visits under half an hour. A security guard at the entrance enforcing hand sanitiser rules. You're not allowed to sit down. Everyone in gloves and librarians not going anywhere near people. Disinfecting books relentlessly. Routine reminders over the speakers about hygiene policy.

It's so weird because the library is attached to a college - which is the final two years of high school - and none of the teenagers right outside the door could care less about the pandemic.

I usually travel overseas one or two times a year, but I'm quite happy to be stuck Down Under for a few years (our borders are closed except to Australians returning home - and those bloody diplomats!) if other countries refuse to be serious about this.
 

Roxxsmom

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Yesterday I heard the ignorant argument that more people are killed by cancer and we don't shut the economy down.

No clue why we are in a lock down, none.

There will be several models, sadly, as to what happens to the economies of countries that don't lock down at all. Sweden is sort of a half-way case. People are trying to self isolate but schools are open. Cases have risen dramatically compared to similar countries. Yet the economy in Sweden is not faring much better at all. There appears to be little to no benefit in not locking the economy down.

My prediction is that even if you don't close schools and businesses down, absenteeism will have a great impact on the economy along with the overwhelming of medical systems. It will take a bit more time to see the effects of the pandemic where it isn't controlled.

And in places like Brazil, one can't help but think Bolsonaro would like to see the favelas depopulated.

I'm pretty sure there are some officials in the US who would like to see certain communities here depopulated as well, even if they can't quite say so openly.

Yet.
 

frimble3

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"What's clear is that they've made things less clear."

I think this is part of the problem. Everybody, experts included, wants COVID19 to be straightforward. Like the flu. They don't want to remember that this is something new, that there are no quick fixes, and no easy solutions.
And it messes with their heads when they think they've got a handle on it, and something new and different happens. This is how it stayed hidden and got ahead of us.
They want things to be clear and there is no clarity. Not yet.
 
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MaeZe

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I can tell you what's wrong here in the US, Trump has his filthy fingers into everything including the CDC.

I need to give some backstory here, some that I have posted before. So warning, boring repetition follows.

I've been involved in infectious disease on the prevention side for the last 30 years. There's always been a bit of politics when it comes to the CDC recommendations. In particular, they will not make a recommendation without a certain amount of evidence if it affects a commercial product. The clearest example is that of two products for tuberculosis skin tests. One is known among those of us who use the products to give more false positives than the other. I asked a rep at the CDC why they don't recommend the test product with fewer false positives. The answer was there is not evidence anyone was harmed by the product with the false positives. I thought that was insane at the time but it gave me better insight into CDC recommendations. I and my colleagues continue to only use the better test.

I have had debates with people who complain that vaccine manufacturers have a seat on the ACIP (Advisory Committee for Immunizations Practices). Manufacturers need to be on that committee because they play a role but that doesn't mean the committee is corrupt.

Until this pandemic I have always been comfortable with the CDC Interim Guidelines. I am an infectious disease consultant for a number of agencies and I'd always recommended going by CDC Interim Guidelines.

But then came Trump. Why Fauci didn't tell him the inconvenient truth is beyond me, but he didn't. And Trump replaced the top CDC official with a lackey. So instead of saying we don't have enough PPE or testing capability because that would expose Trump's personal failures (you all know the details), the head of the CDC actually covered for Trump and instructed the CDC to produce interim guidelines saying no one is contagious without symptoms even though plenty of evidence had emerged that asymptomatic persons could indeed spread the virus. The interim guidelines said testing should be limited to people who had a known exposure.

Back to the point, there is an evidence based answer here. Sadly, Trump has destroyed the confidence in the CDC guidelines. The WHO didn't change their guidelines on wearing masks. In that instance unfortunately words were misunderstood. The WHO has since clarified their position.

The evidence is clear. Wear masks. It prevents the spread of COVID 19. The largest effect is preventing the wearer from spreading the infection. There is a smaller benefit preventing the person wearing the mask from acquiring the infection. Put the two together and it can effectively prevent transmission of most of the coronavirus cases.
 
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Sage

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Well, cases are increasing in our county again, hospitalizations are up, but they're still opening bars, gyms and theaters as of midnight tonight.

https://www.sacbee.com/news/coronavirus/article243486491.html

LA, whose cases are also increasing, is keeping bars and movie theaters closed for the time being.

Bars seem like they should be one of the last things they open. 1. They are not necessary for daily life by any stretch of the imagination. 2. You cannot drink with a mask on. 3. When people are drunk, they're going to get really stupid about social distancing and personal hygiene.

I am rather baffled as to the phase 3 opening priorities. So many outdoor activities have stayed closed until phase 3, even though they seem to be far less risky. People still aren't supposed to play, say, basketball at the park, because of incidental close contact, and children's playgrounds remain closed. How many cases have been contact traced to outdoor basketball between friends or kids on playgrounds? We are opening gyms, where people will be breathing hard, likely not all will be masked, and ventilation may or may not be great.

I need to start exercising again, but I don't think I'd feel terribly safe at the gym.

And they are opening bars--adult playgrounds where a drug that lowers people's inhibitions and good judgment is consumed in quantity.

Since evidence is mounting that mask use really does reduce the spread of the virus, indoor activities where people will be in prolonged contact and masks can't be worn (such as indoor bars, gyms, and restaurants), seem like the last places that should open.
The priority is based off the economy. Nobody is losing money because playgrounds are closed, but bars and gyms and restaurants do risk closing forever because they couldn't sustain business before being "open." Now, my gym is collecting money from me every month (and justifying it with virtual classes, which are probably pretty cheap to put together, especially once they started using premade videos) and restaurants were getting to-go orders from my family the entire time shelter-in-place was happening. I can't tell you if it was enough to cover the costs of staying open (one of our local restaurants is closed forever, I saw yesterday).

I personally do not feel ready to go to the gym or dine in a restaurant. Heck, I'm nervous to have the other three members of my quartet come over to sing in my backyard today. But if you want to understand the priorities, it's about getting businesses up and running again.