Seattle vs. New York Covid comparison sheds some light - Printable Version
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Seattle vs. New York Covid comparison sheds some light - oregontim - 04-26-2020
Fascinating new piece today in the New Yorker: Seattle’s Leaders Let Scientists Take the Lead. New York’s Did Not
Quote:The initial coronavirus outbreaks on the East and West Coasts emerged at roughly the same time. But the danger was communicated very differently.
One of the E.I.S.’s core principles is that a pandemic is a communications emergency as much as a medical crisis. Members of the public entering the hospital, Riedo told his staff, must be asked if they had travelled out of the country; if someone had respiratory trouble, staff needed to collect as much information as possible about the patient’s recent interactions with other people, including where they had taken place. You never know, Riedo explained, which chance encounter will shape a catastrophe. There are so many terrifying possibilities in a pandemic; information brings relief.
...
Epidemiology is a science of possibilities and persuasion, not of certainties or hard proof. “Being approximately right most of the time is better than being precisely right occasionally,” the Scottish epidemiologist John Cowden wrote, in 2010. “You can only be sure when to act in retrospect.” Epidemiologists must persuade people to upend their lives—to forgo travel and socializing, to submit themselves to blood draws and immunization shots—even when there’s scant evidence that they’re directly at risk.
Epidemiologists also must learn how to maintain their persuasiveness even as their advice shifts. The recommendations that public-health professionals make at the beginning of an emergency—there’s no need to wear masks; children can’t become seriously ill—often change as hypotheses are disproved, new experiments occur, and a virus mutates.
...
The lead spokesperson should be a scientist. Dr. Richard Besser, a former acting C.D.C. director and an E.I.S. alumnus, explained to me, “If you have a politician on the stage, there’s a very real risk that half the nation is going to do the opposite of what they say.”
During the H1N1 outbreak of 2009—which caused some twelve thousand American deaths, infections in every state, and seven hundred school closings—Besser and his successor at the C.D.C., Dr. Tom Frieden, gave more than a hundred press briefings. President Barack Obama spoke publicly about the outbreak only a few times, and generally limited himself to telling people to heed scientific experts and promising not to let politics distort the government’s response.
...
By the time Seattle’s schools were formally closed, on March 11th, students and teachers were already abandoning their classrooms. The messaging had worked: parents were voluntarily keeping their kids home. Cell-phone tracking data showed that, in the preceding week, the number of people going to work had dropped by a quarter. Within days, even before Washington’s governor, Jay Inslee, issued official work-from-home orders, almost half of Seattle’s workers were voluntarily staying away from their offices. When bars and restaurants were officially closed, on March 15th, many of them were already empty. Constantine himself had been working from home for a week. He was giving interviews all day, and always underscored to reporters that he was speaking from his bedroom, and that the noises in the background were coming from his children, who were home from school. After he heard that the county’s basketball courts were still being heavily used, he ordered them closed.
...
Today, Washington State has less than two per cent of coronavirus cases in the U.S. At EvergreenHealth, hospital administrators have stopped daily crisis meetings, because the rate of incoming patients has slowed. They have empty beds and extra ventilators. The administrators remain worried, but are cautiously optimistic. “It feels like we might have stopped the tsunami before it hit,” Riedo told me. “I don’t want to tempt fate, but it seems like it’s working. Which is what makes it so much harder when I look at places like New York.”
...
Today, New York City has the same social-distancing policies and business-closure rules as Seattle. But because New York’s recommendations came later than Seattle’s—and because communication was less consistent—it took longer to influence how people behaved. According to data collected by Google from cell phones, nearly a quarter of Seattleites were avoiding their workplaces by March 6th. In New York City, another week passed until an equivalent percentage did the same. Tom Frieden, the former C.D.C. director, has estimated that, if New York had started implementing stay-at-home orders ten days earlier than it did, it might have reduced COVID-19 deaths by fifty to eighty per cent. Another former New York City health commissioner told me that “de Blasio was just horrible,” adding, “Maybe it was unintentional, maybe it was his arrogance. But, if you tell people to stay home and then you go to the gym, you can’t really be surprised when people keep going outside.”
More than fifteen thousand people in New York are believed to have died from COVID-19. Last week in Washington State, the estimate was fewer than seven hundred people. New Yorkers now hear constant ambulance sirens, which remind them of the invisible viral threat; residents are currently staying home at even higher rates than in Seattle. And de Blasio and Cuomo—even as they continue to squabble over, say, who gets to reopen schools—have become more forceful in their warnings. Rasmussen said, “It seems silly, but all these rules and SOHCOs and telling people again and again to wash their hands—they make a brobdingnagian difference. That’s why we study it and teach it.” She continued, “It’s really easy, with the best of intentions, to say the wrong thing or send the wrong message. And then more people die.” ♦
https://www.newyorker.com/magazine/2020/05/04/seattles-leaders-let-scientists-take-the-lead-new-yorks-did-not
RE: Seattle vs. New York Covid comparison sheds some light - burger - 04-26-2020
I was just about to post the same thing. Excellent article definitely worth a read.
Also, regardless of the timing, China didn't force Trump to put the wrong people in charge of the federal response.
RE: Seattle vs. New York Covid comparison sheds some light - BostonCard - 04-26-2020
Were there any problems with the CDC Ebola RT-PCR test? This narrative doesn't raise any issues (though it is from the CDC website):
https://www.cdc.gov/vhf/ebola/history/2014-2016-outbreak/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fvhf%2Febola%2Foutbreaks%2F2014-west-africa%2Findex.html
Quote:Overall, eleven people were treated for Ebola in the United States during the 2014-2016 epidemic. On September 30, 2014, CDC confirmed the first travel-associated case of EVD diagnosed in the United States in a man who traveled from West Africa to Dallas, Texas. The patient (the index case) died on October 8, 2014. Two healthcare workers who cared for him in Dallas tested positive for EVD. Both recovered.
On October 23, 2014, a medical aid worker who had volunteered in Guinea was hospitalized in New York City with suspected EVD. The diagnosis was confirmed by the CDC the next day. The patient recovered.
For the original SARS virus, it was the CDC that announced the sequence: https://www.cdc.gov/sars/lab/sequence.html (after it was found to be a new coronavirus on the basis of Joe DeRisis' viral chip).
The CDC seems to have developed a MERS test without a problem:
https://www.cdc.gov/coronavirus/mers/lab/lab-testing.html
[*]
Quote:Most state laboratories in the United States are approved to test for MERS-CoV by using an rRT-PCR assay developed by CDC. This test is done under authority of an Emergency Use Authorization because there are no FDA-cleared/approved tests available for this purpose in the United States.
As best I can tell, the problems with testing were unique to SARS-CoV-2, and don't seem to be reflective of a systematic problem developing molecular tests at CDC.
BC
EDIT: Note, this post was in response to Goose's now-deleted post, suggesting that the CDC in prior administrations had trouble developing PCR tests.
RE: Seattle vs. New York Covid comparison sheds some light - Genuine Realist - 04-26-2020
(04-26-2020, 06:06 PM)BostonCard Wrote: Were there any problems with the CDC Ebola RT-PCR test? This narrative doesn't raise any issues (though it is from the CDC website):
https://www.cdc.gov/vhf/ebola/history/2014-2016-outbreak/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fvhf%2Febola%2Foutbreaks%2F2014-west-africa%2Findex.html
Quote:Overall, eleven people were treated for Ebola in the United States during the 2014-2016 epidemic. On September 30, 2014, CDC confirmed the first travel-associated case of EVD diagnosed in the United States in a man who traveled from West Africa to Dallas, Texas. The patient (the index case) died on October 8, 2014. Two healthcare workers who cared for him in Dallas tested positive for EVD. Both recovered.
On October 23, 2014, a medical aid worker who had volunteered in Guinea was hospitalized in New York City with suspected EVD. The diagnosis was confirmed by the CDC the next day. The patient recovered.
For the original SARS virus, it was the CDC that announced the sequence: https://www.cdc.gov/sars/lab/sequence.html (after it was found to be a new coronavirus on the basis of Joe DeRisis' viral chip).
The CDC seems to have developed a MERS test without a problem:
https://www.cdc.gov/coronavirus/mers/lab/lab-testing.html
[*]Quote:Most state laboratories in the United States are approved to test for MERS-CoV by using an rRT-PCR assay developed by CDC. This test is done under authority of an Emergency Use Authorization because there are no FDA-cleared/approved tests available for this purpose in the United States.
As best I can tell, the problems with testing were unique to SARS-CoV-2, and don't seem to be reflective of a systematic problem developing molecular tests at CDC.
BC
EDIT: Note, this post was in response to Goose's now-deleted post, suggesting that the CDC in prior administrations had trouble developing PCR tests.
Has anyone - anywhere in the world - developed a satisfactory test? Is this a CDC problem or reflective of the difficulties the virus presents?
(04-26-2020, 01:32 PM)burger Wrote: I was just about to post the same thing. Excellent article definitely worth a read.It was to points like this I wrote the the 'Timelines' post. If there were a catalog of nations that responded quickly and effectively to C-19, this would be a cogent point.
Also, regardless of the timing, China didn't force Trump to put the wrong people in charge of the federal response.
But there isn't. Just on a quick scan, the health ministers of France, Germany, Israel, Romania, Tunisia and so on have all resigned. The reactions of just about every nation in the West were inadequate and identical. I know Trump opponents want to characterize the US as uniquely flawed, but it just isn't so.
A comment of the same sort applies to the New Yorker article. One paragraph leads off with the assertion that Washington State has less than 2% of the C-19 cases in the nation. No problem with that, but I wondered what the population of the State of Washington is. Turns out it's just over 7,000,000 - or, in a nation of 330,000,000, just over two percent. So the statistic is not all that significant, all by itself, which makes you wonder why it leads a topic paragraph, and how many more of the claims may be non-contextualized. All I know for sure is that the authors don;t like DiBlasio very much.
RE: Seattle vs. New York Covid comparison sheds some light - Goose - 04-26-2020
(04-26-2020, 06:06 PM)BostonCard Wrote: Were there any problems with the CDC Ebola RT-PCR test? This narrative doesn't raise any issues (though it is from the CDC website):
https://www.cdc.gov/vhf/ebola/history/2014-2016-outbreak/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fvhf%2Febola%2Foutbreaks%2F2014-west-africa%2Findex.html
Quote:Overall, eleven people were treated for Ebola in the United States during the 2014-2016 epidemic. On September 30, 2014, CDC confirmed the first travel-associated case of EVD diagnosed in the United States in a man who traveled from West Africa to Dallas, Texas. The patient (the index case) died on October 8, 2014. Two healthcare workers who cared for him in Dallas tested positive for EVD. Both recovered.
On October 23, 2014, a medical aid worker who had volunteered in Guinea was hospitalized in New York City with suspected EVD. The diagnosis was confirmed by the CDC the next day. The patient recovered.
For the original SARS virus, it was the CDC that announced the sequence: https://www.cdc.gov/sars/lab/sequence.html (after it was found to be a new coronavirus on the basis of Joe DeRisis' viral chip).
The CDC seems to have developed a MERS test without a problem:
https://www.cdc.gov/coronavirus/mers/lab/lab-testing.html
[*]Quote:Most state laboratories in the United States are approved to test for MERS-CoV by using an rRT-PCR assay developed by CDC. This test is done under authority of an Emergency Use Authorization because there are no FDA-cleared/approved tests available for this purpose in the United States.
As best I can tell, the problems with testing were unique to SARS-CoV-2, and don't seem to be reflective of a systematic problem developing molecular tests at CDC.
BC
EDIT: Note, this post was in response to Goose's now-deleted post, suggesting that the CDC in prior administrations had trouble developing PCR tests.
[*]Hi BC. I deleted my post for other reasons. The test the CDC developed was fine, as far as I know. The problem was, and remains, they were in no way prepared to deliver it nationwide in adequate quantity to use in conjunction with high capacity testing machines. That was the failing, and it was extremely significant and extremely predictable, The CDC has a very good track record of developing tests that can be used on epidemics that are small and controllable. They probably expected this one, initially, to fit that pattern. It didn't, and they had no capacity to meet the need. They had no relationship with Roche, Abbott, etc to deploy large scale tests that would work on the high capacity machines. The CDC also failed to validate some reagents in their tests. Simply not good. The director couldn't bring himself to say it. Fauci could.
[*]
I don't think I ever said they couldn't develop a test. What I did say is that in prior administrations as well as the present one they had no plan to deliver a nationwide test in short order and could not in fact do so. If such a plan ever existed to qualify their tests for large capacity machines and a GMP facility they intended to use to deliver it, I am all ears.