Tuesday, April 21, 2020

San Diego County COVID-19 Metrics

As governments say they are going to use science and data to tell them when to restore our rights, very few have the guts to actual share with us what data and metrics they are using.  For example, the governor of California has release a set of guidelines with no actual measurements.  I tried exchanging emails with a state government staffer but did not get a response on how these metrics are to be met.
But San Diego County health director Dr. Wilma Wooten has taken the time to enlighten the masses on the county's metrics and her take on the state's.  Kudos to Dr. Wooten.  The following is copied from the San Diego Union.  I am not just linking because I don't want it to disappear (my comments in red):

Federal recommendations:
  • Log a downward trajectory of influenza-like illness reported within a 14-day period: Met — In the last 30 days, the percentage of emergency department visits for influenza-like illnesses has dropped from 10 percent on March 16 to 3 percent on April 15.
  • Log a downward trajectory of COVID-like syndromic cases reported within a 14-day period: In progress — Since April 4, the trend has varied.
    These first two bullets are very similar although I am not really sure why the difference matters.  It is much better to track actual cases of the people with the disease then just test results.
  • Log a downward trajectory of COVID-19 cases OR a downward trajectory of positive tests as a percentage of total tests within a 14-day period: Met — Since April 6, the county has seen a downward trajectory in the percentage of positive cases.
    Very important to make this not just a function of the number of tests given and even better to see it trend down.
  • Have the ability to treat all patients without crisis care: Met
    Hospitals have plenty of room right now due their hard work. But one side effect is that people needed "non-essential" procedures are having to wait and many of these are truly worthwhile and not frivolous.  Also, hospitals are losing revenues as they sit under-utilized adding to the economic distress.
  • Establish a robust testing program for at-risk health care workers, including antibody testing: In progress — The county has created a testing task force to increase the region’s testing capacity.
    Why health care workers aren't first in line is beyond me.  Latest reports have the county up to 3000 tests per day but many testing facilities are reportedly under-utilized.  Hopefully the task force can get things going faster.
Notice how the federal recommendations have actual measurable metrics.  Now contrast this with the state...
State recommendations:

  • The ability to monitor and protect our communities through testing, contact tracing and isolating, and supporting those who are positive or exposed: County officials are continuing to increase the region’s testing capacity, which now sits at more than 3,000 tests per day. Officials have also created a testing task force and an action plan to increase contact tracing. More than 1,700 hotel rooms have been obtained to help isolate people who contract the virus, and a University of California San Diego dorm stands at the ready to house COVID-19 patients on the mend.
    The ability to do something is much different than the actual implementation and results.  How about use some under-utilized state employees (or the unemployed) and have them work on manual contact tracing.
  • The ability to prevent infection in people who are at risk for more severe COVID-19: Health officials already strongly recommend that people stay at home if they are older than 65, have chronic medical conditions or have a compromised immune systems. The county is also prioritizing testing for vulnerable populations, hospitalized patients, people in long-term care facilities, health care workers, and essential workers like first responders.
    One of the few hard facts about COVID-19 is that the elderly and those in poor health are greatest at risk.   Again, the ability is there to monitor those that are better off staying home.  How about using under-utilized state employees to check up on these folks.
  • The ability of hospital and health systems to handle surges: Health officials said the number of hospitalizations is decreasing and there are enough beds, staff members and supplies to go around.
  • The ability to develop therapeutics to meet demand: County officials aren’t working on this one at this time.
    Does these mean we need to have effective treatment and in some quantity or that we just have to be working on it?
  • The ability for businesses, schools and child care facilities to support physical distancing: The region’s health order mandates physical distancing in these facilities and requires that social distancing and sanitation protocols be posted at all open businesses. A newly created economic advisory group is working on specific plans to help businesses reopen.
    Done.  Every place I go to has this figured out, except the wide open areas like beaches are deserts for some reason.
  • The ability to determine when to reinstitute measures, such as stay-at-home orders, if necessary: County health officials are continuously monitoring numbers related to the COVID-19 pandemic and are working on determining specific criteria for increasing or decreasing restrictions.
    It would be nice to have a way to figure when you are going to imprison your population and destroy the economy but that might be too much to ask.

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