05-28-2020, 01:59 PM
If someone gets a chance to ask (preferably publicly so the responses can be shared), here are questions I would ask of SCC Public Health Department, regarding contact tracing:
1. You're ramping up to cover up to 75 daily new cases where each case has 40 close contacts. How will you handle a superspreader event that includes people that travel on mass transit? A single individual that travels on Caltrain daily for an hour each way to SF for the two weeks before getting symptoms will surely exceed 40 contacts. And, if he spreads it to others also commuting, they too will exceed 40 contacts (traveling in different train cars on different days). How will you even find the individuals who rode in the same train car as your index patient? In the case of some workers (bus drivers, grocery store clerks, ...) the number of people they may have had contact with may be hundreds or thousands. Will you triage this to limit detection of contacts so you only have a manageable numbers?
2. In your May 26 presentation to the county commissioners, no mention was made of any plans to use the technology developed by Apple and Google for assisting with contact tracing. Does this mean that Santa Clara County has evaluated and rejected this technology, or has it decided that it isn't worth considering, or are you expecting the state to pursue this so SCC is ignoring this for now?
3. Your presentation used the concept of "close contact" but without defining it. Without a definition, we can't know if it includes only the household, or whether it is more expansive so as to include people that work in the same large room, dined in the same restaurant at the same time, rode on the same mass transit vehicle, attended the same meeting (religious, business, social), and service providers (Uber driver, barber, dentist, physician, plumber), etc.
4. 75 daily new cases is a new infection rate of 1.4% of the population per year. While the infection fatality rate is still being understood, and may drop significantly in the future, if we suppose a value of 1%, this is about 270 deaths per year. Unfortunate, but far less than it might be. It also means that it will be decades before herd immunity might be reached if no vaccine is found. Is the current plan to follow this course for the foreseeable future?
1. You're ramping up to cover up to 75 daily new cases where each case has 40 close contacts. How will you handle a superspreader event that includes people that travel on mass transit? A single individual that travels on Caltrain daily for an hour each way to SF for the two weeks before getting symptoms will surely exceed 40 contacts. And, if he spreads it to others also commuting, they too will exceed 40 contacts (traveling in different train cars on different days). How will you even find the individuals who rode in the same train car as your index patient? In the case of some workers (bus drivers, grocery store clerks, ...) the number of people they may have had contact with may be hundreds or thousands. Will you triage this to limit detection of contacts so you only have a manageable numbers?
2. In your May 26 presentation to the county commissioners, no mention was made of any plans to use the technology developed by Apple and Google for assisting with contact tracing. Does this mean that Santa Clara County has evaluated and rejected this technology, or has it decided that it isn't worth considering, or are you expecting the state to pursue this so SCC is ignoring this for now?
3. Your presentation used the concept of "close contact" but without defining it. Without a definition, we can't know if it includes only the household, or whether it is more expansive so as to include people that work in the same large room, dined in the same restaurant at the same time, rode on the same mass transit vehicle, attended the same meeting (religious, business, social), and service providers (Uber driver, barber, dentist, physician, plumber), etc.
4. 75 daily new cases is a new infection rate of 1.4% of the population per year. While the infection fatality rate is still being understood, and may drop significantly in the future, if we suppose a value of 1%, this is about 270 deaths per year. Unfortunate, but far less than it might be. It also means that it will be decades before herd immunity might be reached if no vaccine is found. Is the current plan to follow this course for the foreseeable future?