My Work in COVID-19
Without getting into the details...my work has thrust me into the middle of this current pandemic. As some might know, I'm an engineer working in the medical industry. Much of my work has focused on epidemiology. I know there's a lot of confusing/conflicting info (or hype) out there on this illness. Just want to share that the thing about this that I find most troubling is how contagious this is. We haven't seen anything like it in our hemisphere in my lifetime. I've pressed on some at the CDC on what I have seen as conflicts in the official narrative. Early on I said I thought this was airborne. I'd, more specifically, now say it's the more airborne flu-like illness I've ever heard of. This makes it very dangerous. I have started to reduce my time in/near crowded areas because of this. Will share some info if I can if anybody has questions. I think my kids were already exposed but didn't get this bug about a month ago. Already gone half-Galt I'm keeping a low profile. But, some of my work may be in the news soon. I'd rather this thing just die off before that, though...
Honestly, we can't say enough about a healthy diet, exercise and sufficient rest. I'm not getting nearly enough rest lately and that's not good...
-Every carrier infects X number of other people (and we do not know what X is yet or what all of the means of transmission are)
-Of those X people, Y become sick enough to go and be tested and turn out positive for Covid-19. If we artificially make Y = 100...
-Then, of that 100, ~20 become significantly ill
-And between 1-3 people die
We originally hoped that the X population was not infective, but it looks like many of them are. That means that the community contagion is spreading rapidly through our general population: your own immune system, age and general health will determine your personal risk.
H.sapiens is actually making a surprisingly good showing of rationality in terms of low-granularity decisions to self-isolate and to close public events. People are not waiting for the authorities to do this, eg HIMSS (big medical show) voluntarily canceled last week.
I admit that I have felt a bit like Cassandra, talking to my co-workers about this, though I was able to get some of them to a position of less risk.
Jan
The current kits seem to be very specific for SARS-CoV-2 virus, but they may not be as sensitive as we could hope for. Additionally, many viral diseases take a while to output the viral elements into the blood (they are present in the cells, but not in high numbers in the blood yet). It has turned out that if someone is negative 'now' and you test them again in a few days, they may be positive 'then'.
Jan
So far the data and calculations are showing 1.3 to a max report of 3.3 (that was later revised to 2.2 IIRC).
"H.sapiens is actually making a surprisingly good showing of rationality in terms of low-granularity decisions to self-isolate and to close public events."
Indeed, and this may be a major contributor to reducing the spread. I'm also curious as to the longer term effects of this. By way of example, many companies are doing full-time work from home now - and not just tech people. This will, in my experience, open people up to that notion more and show the company that yes, they can actually do that and be fine. So I wonder how much of a boost remote-work will get out of this. One tech conference I know went virtual this year as well.
I think you are correct about the social changes too.
Jan
On the social changes, Texas govt. offices have been working on remote-work capabilities and coincidentally just completed a WFH test run, determining that, yes, they could do it. I think the other area will be remote-schooling. My daughter's district just cancelled next week and is exploring "distance learning". I wonder just how much of a push this is going to give to that.
Anyway, related to the r0 info is a subset. Looking at the (still limited, but you deal w/what you have ;) ) data on PUI (Person Under Investigation) and "clinically confirmed" that result in lab-confirmed is interesting.
We have a "high" level of "clinal confirmation" because that, perhaps oversimplifying here, means presented with certain symptoms and had contact w/someone confirmed or a PUI". Basically the pipeline (for those not aware, which may not include you ofc) is:
go to hospital -> cough cough wheeze -> PUI (I know so and so and they know so and so who was on a cruise ...) -> lab test.
We are seeing an expected drop in each phase of the pipeline, and this isn't reaching the public's eyes and ears. But what I find interesting is how drastic of a drop we see from PUI/clinical confirmation to lab confirmation. For example, if we take the study from Illinois in the Lancet ( https://www.thelancet.com/journals/la... ) we see that we had a confirmed case from travel with:
A total of 347 contacts
44 conversion to PUI
1 lab confirmed case
Note that this study did the analysis for both from onset of symptoms and from confirmed source infection. The other thing to note is just who that 1 lab confirmed case was: the spouse.
Again, this is a singular case but it was conducted in Illinois, not China, and the results are stark. I wouldn't take it as broadly representative just yet. But it does provide grounds for it not being crazy infectious.
To me it highlights the main* risk factors are poor health (heart disease, diabetes, and pulmonary such as COPD), age, and prolonged close contact. It is also why I am cautious, but not terribly concerned.
And on being busy while WFH, I hear yah! I've been a remote guy for a very long time and it is a huge adjustment. But I can say that once you do ... it becomes almost zen-like at times.
Hmmmm, "distance learning". If that takes off in a manner to replace brick and mortar primary and secondary education in the future I wonder what impact that will have on both parents having to work, teachers unions, indoctrination, and our property taxes.
On parents working, that would be dependent on any interaction with potential increase remote work. Regarding property taxes I'd expect no movement there as districts would likely push for money to provide the home-use computers as well as infrastructure and posy even network access.
Personally, I've seen first-hand that even elementary school grades can be done via remote. My wife used the k12 program for a while and it was just fine. The teachers involved quite liked it in many ways.
I'll also be keeping an eye on urban/suburban migration over the next few years depending on how this plays out. That bit of evidence is undeniable - concentrating people in places increases the chance of infectious disease spreading quickly and broadly.
Note for those not versed in it: r0 can basically be understood as the base rate of infection. Put simply an r0 of 1 means that, on average, a person with it will infect one other person. On average someone with a contagion with an r0 of, say, 12 will infect a dozen people. So, if something has an r0 of less than one it will have a strong tendency to just die out naturally in the outbreak. Calculating the r0 value is complex, even complicated. It is also population dependent and based on the population having no immunity. So a given virus may have higher or lower r0 values based on things such as age ranges, geographical location, and treatment or avoidance measures.
MERS was surprisingly low, but the rest of the major human corona virus based outbreaks have been in the 2-5 range. This would put the SARS-CoV-2 virus at the lower end of that scale with it's current range of 1.3 to 3. Comparing this to others puts more doubt to the claim of more contagious than anything we've seen in your lifetime. Seasonal influenza r0 ranges from 0.9 to 2.1 with a mean of 1.3 - the lower end of this one. Zika: 3-6.6. Norovirus: 1.6-3.7. Whooping cough (Pertussis) is ~5.5, Mumps is 4-7.
Even with a 1.3 r0 - the low end of the range so far - it won't just die off, but that doesn't mean it is one of the most contagious things we've seen in the last, let's say four decades.
As to airborne status, I'd expect one in the field to be more precise in terminology. It is airborne droplets (like influenza, SARS-COV, MERS, etc.), not airborne (like measles). While to some it may seem that is no different, it is critically different. An actual airborne virus is much, much, more difficult to contain than a droplet based one.
In that regard SARS-CoV-2 is no different than SARS-CoV, MERS, Influenza, or whooping cough, so again I wonder what your justification is for claiming "Early on I said I thought this was airborne. I'd, more specifically, now say it's the more airborne flu-like illness I've ever heard of. This makes it very dangerous.".
For those who do not know the key differences between airborne and droplet: if it was an actual airborne virus washing hands and surfaces would make no difference, neither would avoiding touching your face. Airborne viruses require significant isolation - down to the atmosphere in the quarantine rooms - and gloves and masks don't help. For droplet spread ones, as SARS-CoV-2 is, gloves, high quality masks, and cleaning does make a difference and you can contain by avoiding physical proximity even while in the same atmosphere. An actual airborne virus gets into you by you breathing it in. A droplet based transmission means you have to have physical contact and ingest via ayes, mouth, nose, etc. droplets containing the virus.
Now to be clear, I'm not questioning you personally, just asking how you justify your claims when they are contrary to all of the available data and virus biology. You may have valid reasons for some of them, but they aren't being presented; and some of your claims go against well known virology. As such I am asking on what evidence and data you base these claims.
But, I just read and think. Everybody takes in different information. I'm not going to shovel out my sources. And, everybody can think whatever they want to think. It's somewhat possible this thing may fade away in a month or so, then show up again in the next "cold and flu season", based on a collection of conditions. We'll see. I appreciate your commentary.
THIS is the single best advice. Vitamin D, C
and ZINC (Bill Still has a video showing that Zinc stops this thing from replicating, and a specific drug helps the cells let the Zinc in. China is HIDING this after figuring it out. LMAO, we cannot trust them folks)
Vitamin D:
https://www.youtube.com/watch?v=v3pK0...
Just don't take zinc on an empty stomach. Must be with food.
Vitamin D:
https://www.youtube.com/watch?v=v3pK0...
D-3 with K-2 daily since last fall. Perhaps I should up it a bit. I also use 7,500 IU of a multi-carotene product at least 3x each week. I also suspect that the virus may be airborne because of the increase in community transmission.
https://youtu.be/W5yVGmfivAk
https://www.washingtonpost.com/graphi...
By John Bowden - The Hill 03/11/20
"... tests conducted by scientists from several major institutions indicated that the novel form of coronavirus behind a worldwide outbreak can survive in the air for several hours.
"A study awaiting peer review from scientists at Princeton University, the University of California-Los Angeles and the National Institutes of Health (NIH) posted online Wednesday indicated that the COVID-19 virus could remain viable in the air 'up to 3 hours post aerosolization,' while remaining alive on plastic and other surfaces for up to three days.
" 'Our results indicate that aerosol and fomite transmission of HCoV-19 is plausible, as the virus can remain viable in aerosols for multiple hours and on surfaces up to days', reads the study's abstract.
"The test results suggest that humans could be infected by the disease simply carried through the air or on a solid surface, even if direct contact with an infected person does not occur..."
https://thehill.com/policy/healthcare...
As someone with more insight to the epidemic than most, what is your informed prediction how bad it will get before it gets better?
Will it get any better?
My take has been that by the numbers it is not even close to H1N1.
As you said, being airborne makes it very dangerous and that is why it's exponentially difficult to contain.
People's movements must be curtailed. Some victims were frequent travelers: did they consider what the consequences will be?
It isn't airborne in the sense that matters, it is airborne droplet - just like H1N1. Containment is fundamentally no different from a process/procedure perspective.
"Some victims were frequent travelers: did they consider what the consequences will be?"
So, story time. Back in the 80s I was part of an agency that prepared/planned for stuff like this. The primary thing we talked about regarding broad transmission was what we called "super carriers" - people who travelled frequently and to high traffic/population areas. The modeling showed that if we, when faced with an outbreak the most important thing you could do to stop it was to lock down most of the "super carriers". Absent them more than 90% of outbreaks would be contained/eliminated.
Had we had the data/tech we do today, I have no doubt we'd have used it in our planning. Even then we knew the names of the vast majority of the American "super carriers".
That said, essentially we're talking Pareto Principle in regards to the "super carriers". But the effect is/was to drop that r0 value below 1. If you can do that, you've got it beat. However, realizing this the question of curtailing movement switches.
It is one thing to shut down travel broadly - such as all flights in/out of a hot zone - and another to stop that tiny minority from travel. Now here I kinda need to clarify just a bit about the work I was involved in in the 80s. While the basic principles and processes are the same, bioweapons are a bit different than natural viruses. However, IMO if you want to know the best way to stop something, consult the people who figure out the best way to spread it.
An alternative is mandatory quarantine/isolation. From a "freedom" perspective it can be thorny to consider travel limitations and/or physical quarantine. The sticky wicket is the post-operational period. Don't do enough or target the wrong population and you decrease confidence and justification for it. Go too far and you build resentment. The catch there is in the beginning you don't know how hard to go, and if you go hard enough it will look like you overreacted.
"The researchers estimate that the pandemic virus caused 201,200 respiratory deaths and another 83,300 deaths from cardiovascular disease associated with H1N1 infections. They also calculate that Africa and Southeast Asia, which have 38% of the world's population, accounted for a disproportionate 51% of the deaths."
"It isn't airborne in the sense that matters, it is airborne droplet - just like H1N1. Containment is fundamentally no different from a process/procedure perspective."
Coronavirus is airborne: it can survive up to three hours in the environment. That is probably how people who did not fall into any category established contacted it. There may have been a super-carrier in the room saturating the air with the virus, that others entered into. That is why masks don't protect against COVID-19.
There is another aspect that is sobering: there are all indications that it is a manufactured virus (HIV DNA in the virus's makeup) and people don't develop immunity against it: there were cases of re-infection.
As for what is the best way to control the epidemic, compare how Cuba handled the HIV epidemic vs the US. Cuba ordered draconian measures, with complete control over the lives of those infected, whereas that was not the case in the us. The results speak for themselves.
"Coronavirus is airborne: it can survive up to three hours in the environment."
How along a virus can live outside of a host isn't the qualification for an airborne virus vector. It is based on physical properties. Properties that have not been found in any studies. To date, precisely zero SARS-CoV-2 infectious virus has been found aerosolized. Zero. The critical distinction is that for it to be considered airborne the virus has to remain infections after it has become a dried husk - not while it still has moisture.
"That is why masks don't protect against COVID-19."
No, masks don't work because masks don't protect you from catching an airborne droplet virus. They do not protect the eyes, for example, and they are not a sealed device. The latter means that there is still leakage around the sides. Indeed, masks are advised against unless you are sick because the constant fiddling with their positioning causes you to tough your face - especially around nose and mouth - frequently thus increasing the risk of transferral from hands to the parts that matter.
Adding to the problem with masks is that they lack the ability to prevent inbound infiltration through them to your lips, mouth, eats, and nose - basically mucus membranes. Think about it this way: if you put water on the outside mask, will it penetrate it? Yes. With the virus contained in that water, will the virus also penetrate it? Yes.
Surgeons wear masks to protect the patient from the surgeon, not the surgeon from the patient. Indeed, not even for SARS were masks recommended for those who didn't already have it (or something else).
No scientific studies so far indicate airborne transmission - just droplets that can be carried for short times via airborne. hence "airborne droplet". Scientists tend to be a cautious slot and say we haven't ruled it out yet, but that isn't the same as having ruled it in.
By contrast, an actual airborne virus is aerosolized - the carrier fluid is rapidly evaporated and the virus bodies themselves float along in the air. Measles is the prime example here. MERS is another case (and a corona virus) where we did manage to obtain infectious virus husks from air samples.
Further, if SARS-CoV-2 were aerosolized rather than dropletized, the cruise ships would have had far greater infection rates. There is a reason the r0 value of true airborne viruses is an order of magnitude more than those that are droplet based.
If you've got some, by all means link actual studies rather than your assumptions of "probably". Otherwise, you are contradicting all available research. And don't worry if the published data and research is behind a paywall, I have access to a wide array of journals. Chances are that if it is reputable I have access to it.
And there are no scientific indications of it being "manufactured", despite the paranoid or attention seeking ramblings of it by people who don't understand the published science.
It may help to do your research on the subject.
Did that study with the 3 hour result add anything new to what was already known?
I woman in her forties just died recently in CA who was a frequent global traveler, her last trip to an Asian country.
I am far from advocating government regulating travel of people but some sort of measure is absolutely necessary. Relying on people to control their own moves did not seem to work in the past.
H1N1 had a lesser death rate than covid-19 appears to have but infected tens of millions.
Although I am not particularly concerned about myself, as I haven't been sick enough to go to the doctor in over five years (my point being that I likely will recover okay if I get it), my husband can't even recover from a common cold without help. I am very concerned about him.
Anyway back to the point: thanks for letting us know you have some insight. And given that so many of us are over that "magical" age of 70, including myself, we can probably use all the help we can get!
1) By age group, what percentage of the people exposed actually dont get sick at all.
2) Of the remaining group, what percentage get sick, but recover without problems.
3) Of the people who do get sick, how what percentage actually are very sick and need hospitalization, and
4) Of the people who require hospitalization, what percentage actually die
These answers would be a lot more useful to assess my chances of dealing with this.
MOST people exposed do not get it. Most people who become "Persons under Investigation" do not get it. Most people who are "presumptively/clinically confirmed" do not have it. This can also be seen by the low r0 value of 1.3 to 2.3 - meaning on average (globally) one person will infect 1.3 to 2.3 people. Removing the province where Wuhan is shows a much lower rate. Some work puts that down in the 0.4 to 1.2 range; but let us not take that as fully conclusive just yet either as we are dealing with much smaller levels once you exclude that province.
Unfortunately a lot of the data you're looking for is region specific. The sole common factors that are universal are 1) getting exposed (duh!) and 2) been over 70 years of age. On elf the reasons you want to exclude the data, to some degree, from the Wuhan area is that there is believed to be two transmission factors there: zoonotic (the fish market) and human to human and that is suspected as the reason it grew so fast.
Even within China the rates vary dramatically. For example, in the province Wuhan is in (Hubei), the overall case fatality rate is 2.9. Outside of that province, though still in China, it is 0.4%. We see this happen in the U.S. as well. As I've mentioned elsewhere here, of the 39 deaths in the U.S., 31 are from Washington, and almost all of those from King County, and over half of those from a single nursing home. This kind of thing really messes with attempts to quantify risks.
Another example is the Caribbean Princess ship, which had 2 crew members transfer from the Grand Princess. That ship had 21 cases. Out of over 2400 people aboard. The Diamond Princess (the one EVERYBODY has heard about) the r0 was 2.28. Frankly, given the circumstances, that is not as high as I'd have expected. To add to that, those were the values computed from the early days of the ship outbreak.
Regarding your item (3), again it is complicated. Mostly you have to break it out by pre-existing conditions. Even if you happen to be over 70, if you don't have chronic disease, diabetes, heart or lung problems, or already are sick, the odds are somewhat in your favor.
From the provincial data, around 95% of those who actually went (or were taken) to a facility didn't require hospitalization. Of that remaining 5% the CFR is about 49% - again in the Hubei province.
You can also look at https://www.thelancet.com/journals/la... which, while "small scale" is a rather tight study.
I've summarized the findings there elsewhere on this page, will not repeat them here. ;) Basically out of over 300 people exposed or thought to be exposed, only 1 - the spouse - got it at all.
My apologies for not laying it out as clear and simple as either of us would like, but that is basically where we are at the moment. Also, we've hit the point were more than half of total cases have hit a "recovered state" - and that doesn't include deaths. This may be a sign we're past the bulk of it, but we won't really know for another week or two as we see how things run in the more recent cases.
I do think that keeping ones immunity up is the best defense against this virus. Rest, and common sense based staying away from sick people and reducing unnecessary contact with other humans will go a long way to staying alive.
Washing hands?...make sure your water is 100 degrees...that is what kills the virus, not the soap.
Here is something else:
Interesting connection I just made.
Why did the UN change Agenda 21 to Agenda 2030?
Now...read what was predicted in 08...and was predicted 40 yrs before that!
https://www.indiatoday.in/trending-ne...
For example:
From the linked article:
"Further, the science paper finds that there is no known viral ancestry to the CoVid-19 coronavirus, meaning it did not evolve from nature."
From the source paper:
"Based on its genome sequence, 2019-nCoV belongs to lineage b of Betacoronavirus (Fig. 1A), which also includes the SARS-CoV and bat CoV ZXC21, the latter and CoV ZC45 being the closest to 2019-nCoV. 2019-nCoV shares ~76% amino acid sequence identity in the Spike (S)-protein sequence with SARS-CoV and 80% with CoV ZXC21 (Chan et al., 2020)."
and the full context of the cherry-picked quote from the article:
"This furin-like cleavage site, is supposed to be cleaved during virus egress (Mille and Whittaker, 2014) for S-protein “priming” and may provide a gain-of-function to the 2019-nCoV for efficient spreading in the human population compared to other lineage b betacoronaviruses. This possibly illustrates a convergent evolution pathway between unrelated CoVs. Interestingly, if this site is not processed, the S-protein is expected to be cleaved at site 2 during virus endocytosis, as observed for the SARS-CoV."
So no, the authors of the paper are not implying in any way this was bioengineered to kill humans. Indeed, reading further they indicate that this is nothing new and is possibly a route to treatment as it has been in other cases. I will also note that the implication the article's authors make is that because a new virus pops up and we don't know its ancestry, it must be a bioweapon engineered by man is absurd and unsupportable.
Scaremongers and conspiracists tend to only read abstracts - to the extent they even bother. But here, even the original paper's abstract makes no such claims:
"In 2019, a new coronavirus (2019-nCoV) infecting Humans has emerged in Wuhan, China. Its genome has been sequenced and the genomic information promptly released. Despite a high similarity with the genome sequence of SARS-CoV and SARS-like CoVs, we identified a peculiar furin-like cleavage site in the Spike protein of the 2019-nCoV, lacking in the other SARS-like CoVs. In this article, we discuss the possible functional consequences of this cleavage site in the viral cycle, pathogenicity and its potential implication in the development of antivirals."
Note that this paper is over a month old, and since it was published the actual virus has been named SARS-CoV-2 because it is not different enough genetically from SARS-COV (-1) to get its own classification.
The article plays slight of hand with selective quoting and letting the reader fill in the blanks with fear. The article author clearly wants you to think it is unique, but the original paper shows it isn't. For example the article reads “The spike glycoprotein of the new coronavirus 2019-nCoV contains a furin-like cleavage site absent in CoV of the same clade.”
But they fail to point out that, as the original paper clearly shows, the cleavage site is present on a bit more than half of CoV overall. Further the article adds emphasis around a claim that the virus is efficiently spread among humans, insinuates this is demonstrative of engineering. But here is the lie: if the virus was not "efficient" in spreading in humans would we be having an epidemic? Of course not.
Something important to keep in mind in all this is that corona virus is a family of viruses that exists across species. Sometimes these viruses mutate and "jump" species. This isn't new or unique. The genetic lineage of SARS-COV-2 indicates a bat origin.
For example a related paper still awaiting peer review indicates:
"At the whole genome level, the sequence identify of SARS-CoV-2 was 50% to MERS-CoV, 79% to SARS-CoV, 88% to two bat-derived SARS-like coronaviruses, Bat-SL-CoVZC45 and Bat-SL-CoVZXC21 (collected in 2018 in Zhoushan, China), and 96% to Bat-SARSr-CoV RaTG13 (collected in 2013 in Yunnan, China)"
"According to random drift hypothesis (15), these nucleotide mutations among different SARS-CoV-2 strains now available are still determined by neutral evolution. In short, there has no powerful factor to force SARS-CoV-2 to evolve in a certain direction by far. However, we should take strict precautions against the strong factors that may cause directional variation of SARS-CoV-2 both in natural environment and infection treatment."
TL;DR: no, the analyses we have so far are not indicative of it being a human engineered bioweapon.
So do all the precautions (washing hands well and often; sanitation surfaces, avoid crowds and touching of the face, etc.
In US, since December 30 people have died from corona virus, as of yesterday. This flu season, an annual event. as high as 34,000 have died from the flu. The media is not talking about it, and events are being cancelled, etc.every flu season Maybe it's just because it's only the flu, eh? As for me and my family, we'll take the prudent precautions, but I'm not going to join the panic others are experiencing. Whenever I start getting sucked in, I turn off the news for a while.
Seems to me that the United Nations' WHO declares a pandemic and more funds gets assigned to it. Like someone we know said, never let a good crisis go to waste.
The CDC director who has been at CDC for many years says we are not as prepared as we should have been. Well, why not. Who's fault would that be since he was in charge. If I were Trump, I'd say "You're fired" and replace him immediately.
Perhaps cynicism is creeping in as a grow older.
Sort of to the former, and yes to the latter. It is transmitted by droplets. This means you have to not only come into contact with the droplets but do so at a place they can ingest - it doesn't absorb via the skin. Th general public is not well educated on airborne vs airborne droplet transmission. The movies tend to go for actual airborne displays and scientists report "airborne droplet so that doesn't help.
An airborne droplet is a droplet that can cover short distances suspended in the air for short periods of time. Think of someone sneezing or coughing. By contrast an airborne virus is floating in exhaled breath.
As to contagion, the data and research we have so far puts the range of average transmission in the 1.3 to 3.3 range. Which means on average one person will infect 1.3 to 3.3 other people. So yes to contagious, but with the caveat that it isn't super contagious as some claim. It is presently less contagious than whooping cough, for example, which is also spread via droplets and airborne droplets and has an r0 of about 5.5.
You can always say we were not as prepared as we "should" have been - for something new. Those kind of claims are generally done to deflect blame - which isn't always warranted but still thrown.
The WHO delayed recognizing it as a pandemic well beyond their own published standards. It had met the criteria for stage 6 for weeks before they did. The reality is there really isn't much actual news so they all-"news"-all-the-time companies glom onto something they can scaremonger with because the human brain is wired to pay more attention to danger signs.
It makes me remember a Bill Engvall(?) bit:
"This doll looks safe enough doesn't it" like we're all at home going "uh-huh!" "But what if Barbie skated through a pool of gasoline*?!" -- https://youtu.be/rISEOKSbcko?t=195
Whatever other decisions you make, please do not base them on the idea that this 'may be just the flu'
Jan
CDC and WHO...Uh, have your grains of salt ready.
https://www.saccounty.net/news/latest...