[Snorlax94]

An interesting interview with Dr. Sara Cody, health officer for Santa Clara County

The most depressing quote, for me:
“The Chinese city of Wuhan, the epicenter of the outbreak, brought in 1,500 epidemiologists to conduct “contact tracing,” assigning five experts to every single case, according to Dr. Michele Barry, Senior Associate Dean for Global Health at Stanford University’s School of Medicine.
“We can’t use that same strategy” due to short staffing, said Cody. “Trying to map and figure out where are some hotspots for transmission — we really don’t have the data to enable us to do that. That’s still a pretty fuzzy part of the picture.”
Instead, the country is focusing its efforts on detecting outbreaks when they occur in easily recognized groups — particularly among people who are at high risk, such as residents of long-term care facilities, she said.”

https://www.mercurynews.com/coronavirus-...ara-county

It makes me worry that even after the lockdown, even if the local cases are greatly reduced, the only tool in the toolbox is still the hammer.

Many billions of regional economic dollars are at stake in Silicon Valley. Would it be possible to ramp up staffing to conduct contact tracing in the future?

[Snorlax94]

An interesting interview with Dr. Sara Cody, health officer for Santa Clara County

The most depressing quote, for me:
“The Chinese city of Wuhan, the epicenter of the outbreak, brought in 1,500 epidemiologists to conduct “contact tracing,” assigning five experts to every single case, according to Dr. Michele Barry, Senior Associate Dean for Global Health at Stanford University’s School of Medicine.
“We can’t use that same strategy” due to short staffing, said Cody. “Trying to map and figure out where are some hotspots for transmission — we really don’t have the data to enable us to do that. That’s still a pretty fuzzy part of the picture.”
Instead, the country is focusing its efforts on detecting outbreaks when they occur in easily recognized groups — particularly among people who are at high risk, such as residents of long-term care facilities, she said.”

https://www.mercurynews.com/coronavirus-...ara-county

It makes me worry that even after the lockdown, even if the local cases are greatly reduced, the only tool in the toolbox is still the hammer.

Many billions of regional economic dollars are at stake in Silicon Valley. Would it be possible to ramp up staffing to conduct contact tracing in the future?

[OutsiderFan]

Man does that interview drive home just how much the CDC failed to do its job.  Might as well be called the Center for Disease Growth and Economic Destruction.

The most useful planning nugget I got from Dr. Cody was that 5% of infections require hospitalization. That's what Italy's numbers now show, but I wonder if Italy is bringing more people into the hospital than the U.S. is. I've heard two stories from people who are quite sick and I think under normal circumstances would be taken in by hospitals, but now have been told to stay home basically until they can't breathe.

Italy reports many of its transmissions have occurred at hospitals, so in addition to preserving capacity, it may the the U.S. is adopting a strategy to only deal with the most critical patients at hospitals as another way to reduce spread. Critical status would be those who have a blood oxygen of less tan 94% and need external oxygen or ventilator to breathe.

[OutsiderFan]

Man does that interview drive home just how much the CDC failed to do its job.  Might as well be called the Center for Disease Growth and Economic Destruction.

The most useful planning nugget I got from Dr. Cody was that 5% of infections require hospitalization. That's what Italy's numbers now show, but I wonder if Italy is bringing more people into the hospital than the U.S. is. I've heard two stories from people who are quite sick and I think under normal circumstances would be taken in by hospitals, but now have been told to stay home basically until they can't breathe.

Italy reports many of its transmissions have occurred at hospitals, so in addition to preserving capacity, it may the the U.S. is adopting a strategy to only deal with the most critical patients at hospitals as another way to reduce spread. Critical status would be those who have a blood oxygen of less tan 94% and need external oxygen or ventilator to breathe.

[Mick]

Man does that interview drive home just how much the CDC failed to do its job.  Might as well be called the Center for Disease Growth and Economic Destruction.

The most useful planning nugget I got from Dr. Cody was that 5% of infections require hospitalization. That's what Italy's numbers now show, but I wonder if Italy is bringing more people into the hospital than the U.S. is. I've heard two stories from people who are quite sick and I think under normal circumstances would be taken in by hospitals, but now have been told to stay home basically until they can't breathe.

Italy reports many of its transmissions have occurred at hospitals, so in addition to preserving capacity, it may the the U.S. is adopting a strategy to only deal with the most critical patients at hospitals as another way to reduce spread. Critical status would be those who have a blood oxygen of less tan 94% and need external oxygen or ventilator to breathe.

Makes sense, I suppose. I've gone to the E.R. twice with severe breathing difficulty over the past few years (variety of reasons). I couldn't speak, could barely breathe, and in one instance I literally crawled to the ER front desk. I didn't get near an oxygen tank or a ventilator. I wonder what the threshold is for that type of assistance now?

[Mick]

Man does that interview drive home just how much the CDC failed to do its job.  Might as well be called the Center for Disease Growth and Economic Destruction.

The most useful planning nugget I got from Dr. Cody was that 5% of infections require hospitalization. That's what Italy's numbers now show, but I wonder if Italy is bringing more people into the hospital than the U.S. is. I've heard two stories from people who are quite sick and I think under normal circumstances would be taken in by hospitals, but now have been told to stay home basically until they can't breathe.

Italy reports many of its transmissions have occurred at hospitals, so in addition to preserving capacity, it may the the U.S. is adopting a strategy to only deal with the most critical patients at hospitals as another way to reduce spread. Critical status would be those who have a blood oxygen of less tan 94% and need external oxygen or ventilator to breathe.

Makes sense, I suppose. I've gone to the E.R. twice with severe breathing difficulty over the past few years (variety of reasons). I couldn't speak, could barely breathe, and in one instance I literally crawled to the ER front desk. I didn't get near an oxygen tank or a ventilator. I wonder what the threshold is for that type of assistance now?

[M T]

The most useful planning nugget I got from Dr. Cody was that 5% of infections require hospitalization. That's what Italy's numbers now show, but I wonder if Italy is bringing more people into the hospital than the U.S. is.

The reporter (not Dr. Cody) wrote

Yet people with minor illness can unwittingly transmit the virus to others, with catastrophic consequences for an estimated five percent of those affected.

Italy passed the naive CFR of 5% two weeks ago.
The Italy numbers currently are 59,138 confirmed, 5476 deaths, 7024 recovered.  The naive CFR is currently 9.3%. 
It will rise above that (I'd guess by a factor of roughly 2).     Those that want to divide it by 2 for presumed asymptomatic infections, will use 4.65% Infection Fatality Rate.  

Maybe the report had the old Italy numbers for fatalities (not hospitalizations) in mind.

Why are Italy's numbers worse than China's numbers?  For one thing, demographics.  Italy has a much higher percentage (roughly a factor of 2) older people.
I calculated the age group CFRs for Italy, and their overall CFR came up that it should be double China's, if all the treatment was the same.

Secondly, Italy is losing more patients due to a greater overrun of its health care system.  Patients that might have survived, aren't.

[M T]

The most useful planning nugget I got from Dr. Cody was that 5% of infections require hospitalization. That's what Italy's numbers now show, but I wonder if Italy is bringing more people into the hospital than the U.S. is.

The reporter (not Dr. Cody) wrote

Yet people with minor illness can unwittingly transmit the virus to others, with catastrophic consequences for an estimated five percent of those affected.

Italy passed the naive CFR of 5% two weeks ago.
The Italy numbers currently are 59,138 confirmed, 5476 deaths, 7024 recovered.  The naive CFR is currently 9.3%. 
It will rise above that (I'd guess by a factor of roughly 2).     Those that want to divide it by 2 for presumed asymptomatic infections, will use 4.65% Infection Fatality Rate.  

Maybe the report had the old Italy numbers for fatalities (not hospitalizations) in mind.

Why are Italy's numbers worse than China's numbers?  For one thing, demographics.  Italy has a much higher percentage (roughly a factor of 2) older people.
I calculated the age group CFRs for Italy, and their overall CFR came up that it should be double China's, if all the treatment was the same.

Secondly, Italy is losing more patients due to a greater overrun of its health care system.  Patients that might have survived, aren't.

[Goose]

Man does that interview drive home just how much the CDC failed to do its job.  Might as well be called the Center for Disease Growth and Economic Destruction.

Not that it much matters at the moment, but I am quite sure that Dr. Cody was well aware six months ago that if this type of event did occur that she didn't have adequate capacity to respond. I am also quite sure that she, the California Department of Public Health, and the USPHS knew it also. The CDC is not the part of the federal government that would be most involved in the actual response. The USPHS is, FWIW. I am also quite sure we could find all kinds of reports from the CDC outlining what would be required of these agencies sitting in may filing cabinets. Unfortunately, this type of event was not a priority for anybody, you and I included.
This isn't rocket science, unfortunately. How to conduct this kind of epidemiology is well known and has been well known for a long time. New technology can be a force multiplier, but when you are multiplying by essentially zero, it doesn't help as much as one would hope. We just don't have the people, and it is hard to create a force in the middle of a battle. Hopefully, we can do it.
What I find real disturbing is that I see no evidence that the states that at present have a manageable number of cases, like even West Virginia, have mounted any serious epidemiological response. As I have posted previously, I believe that California already had too many undetected pockets of the disease early on to beat it back that way, but these other states are not in that condition. Yet, it doesn't seem to be happening.

[Goose]

Man does that interview drive home just how much the CDC failed to do its job.  Might as well be called the Center for Disease Growth and Economic Destruction.

Not that it much matters at the moment, but I am quite sure that Dr. Cody was well aware six months ago that if this type of event did occur that she didn't have adequate capacity to respond. I am also quite sure that she, the California Department of Public Health, and the USPHS knew it also. The CDC is not the part of the federal government that would be most involved in the actual response. The USPHS is, FWIW. I am also quite sure we could find all kinds of reports from the CDC outlining what would be required of these agencies sitting in may filing cabinets. Unfortunately, this type of event was not a priority for anybody, you and I included.
This isn't rocket science, unfortunately. How to conduct this kind of epidemiology is well known and has been well known for a long time. New technology can be a force multiplier, but when you are multiplying by essentially zero, it doesn't help as much as one would hope. We just don't have the people, and it is hard to create a force in the middle of a battle. Hopefully, we can do it.
What I find real disturbing is that I see no evidence that the states that at present have a manageable number of cases, like even West Virginia, have mounted any serious epidemiological response. As I have posted previously, I believe that California already had too many undetected pockets of the disease early on to beat it back that way, but these other states are not in that condition. Yet, it doesn't seem to be happening.

[OutsiderFan]

What is USPHS?  Is this some division of a Federal Department, like Heath and Human Services?

[OutsiderFan]

What is USPHS?  Is this some division of a Federal Department, like Heath and Human Services?

[Goose]

What is USPHS?  Is this some division of a Federal Department, like Heath and Human Services?

The United States Public Health Service is a division of Health and Human Services. They are headed by the Surgeon General.

[Goose]

What is USPHS?  Is this some division of a Federal Department, like Heath and Human Services?

The United States Public Health Service is a division of Health and Human Services. They are headed by the Surgeon General.