Is California ready? - Printable Version
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+--- Thread: Is California ready? (/thread-19607.html)
Is California ready? - Leftcoast - 05-02-2020
So as California inches closer to Phase 2, how are we doing? I'd enjoy hearing where the Cardboard places us on a 5 point scale ranging from 1 (Not ready at all) to 5 (Let's reopen now) graded against the thresholds set in March. (For the mods/Devs - I tried to post this as a poll but got a BBS SQL error when I put in a vote. Do polls work?)
As a reference, the American Enterprise Institute released a well received report on phases of Pandemic response that guided many governors including California's own Governor Newsom. The thresholds recommended for moving from Stage 1, "Slow the Spread" to Stage 2, "Reopen State by State", were as follows (direct quote from article):
A state can safely proceed to Phase II when it has achieved all the following:
- A sustained reduction in cases for at least 14 days,
- Hospitals in the state are safely able to treat all patients requiring hospitalization without resorting to crisis standards of care,
- The state is able to test all people with COVID-19 symptoms, and
- The state is able to conduct active monitoring of confirmed cases and their contacts.
Quote:In Phase II, the majority of schools, universities, and businesses can reopen. Teleworking should continue where convenient; social gatherings should continue to be limited to fewer than 50 people wherever possible. Other local restrictions should be considered, such as those that limit people from congregating in close proximity.
High-contact settings such as schools should continue to review and implement physical distancing measures with guidance from the CDC and input from local officials. Health officials should recommend increased social hygiene measures and cleaning of shared surfaces.
For older adults (those over 60 years old), those with underlying health conditions, and other populations at heightened risk from COVID-19, it should still be recommended that they limit time in the community during Phase II. This recommendation may change if an effective therapeutic becomes available.
https://www.aei.org/research-products/report/national-coronavirus-response-a-road-map-to-reopening/
RE: Is California ready? - Snorlax94 - 05-02-2020
I don’t agree with all of the AEI’s framework. First, I saw only 3 phases (not 5) . Second, I don’t think schools should be one of the earliest things to open. Third, unlike Governor Newsom’s framework, I didn’t see emphasis on the need to have systems in place to protect the elderly and vulnerable, besides telling them to stay at home.
But to your question of what stage are we in and are we ready, The link didn’t work for me but Unfortunately the big catch is:
“We recommend that no state relax physical distancing until... it's able both to test all people with COVID-19 symptoms, and conduct monitoring of confirmed cases and their contacts.”
I don’t think CA — or any state at this time — is testing all people with symptoms and monitoring confirmed cases and their contacts. I don’t think we’re close to that yet, so by the AEI framework, we — and probably all states — are unfortunately a ways away, maybe months.
I do think some counties in CA have good numbers and could ease some sensible items soon — like permitting curbside pickup and some outdoor businesses and more socially distant outdoor recreation, but not the aei phase 2 with opening schools. Going that far could really squander the progress we’ve made so far.
As many others have noted, the slow progress on testing and contact tracing have been ruinous for the country.
RE: Is California ready? - M T - 05-02-2020
This report lays out why the authors feel that
1) automated contact tracing will require too high a participation rate
2) the fact that contact tracing has worked for other diseases may not be applicable for COViD-19
Griffins78 - Griffins78 - 05-02-2020
Does anyone understand the logic behind limiting to “groups of 50?” It does not seem like that would limit the spread since many of the hot spots involved groups less than 50. If sustained contact within close quarters with one infected person is all you need - smaller groups tend to be the kind of social engagements that are conducive to spreading the virus.
RE: Is California ready? - Goose - 05-02-2020
(05-02-2020, 03:47 AM)M T Wrote: This report lays out why the authors feel that
1) automated contact tracing will require too high a participation rate
2) the fact that contact tracing has worked for other diseases may not be applicable for COViD-19
The report is very interesting IMHO because it is the first such report I have seen that addresses the effect of presymptomatic transmission on the efficiency of contact tracing. There are two assumptions in our plans to return to "normal": 1) We can organize an effective contact tracing effort (a fact not yet in evidence) and 2) This effort can at a minimum keep the incidence of the disease "low enough" that it will not expand exponentially again. If the second assumption is wrong, we are in real trouble. The fact Taiwan, HK, and Korea have managed to do so is encouraging, but it certainly isn't as simple as most of our previous experiences.
RE: Is California ready? - M T - 05-03-2020
This may be relevant to the discussion of trace & test:
Enhanced Contact Investigations for Nine Early Travel-Related Cases of SARS-CoV-2 in the United States
For 9 index travel-related cases Jan 19-Jan 30, they identified 404 close contacts to monitor (additional 149 low-risk or out-of-jurisdiction contacts were not monitored), 159 of which had at least one RT-PCR test as part of the process. Of those, it appears the only secondary infections were 2 spouses (2/15 = 13% of household members of the 9 cases).
Referring to a subset of 338:
"Of these 338 close contacts, 15 (4%) were household contacts, 163 (48%) were HCP, 95 (28%) were community contacts exposed in a healthcare setting, and 65 (19%) were community contacts exposed in another setting"
Referring to a couple where the travel-associated case got symptom one day after return, and the spouse got symptoms 3 days later:
"the travel-associated case patient wore a face mask and used a separate bedroom and
bathroom even prior to developing symptoms, although the couple did share a meal and spent extended time in
the car together"
(The other couple's situation is more confounded. They did not practice isolation.)
There are more details about exposure of other household members of the 9.
I saw no information as to the geographic region of any of the cases.
One can imagine that health care workers might be traced for multiple exposures.