[Goose]

 Unfortunately, as of now, I see little evidence that San Mateo County, San Francisco County, and Santa Clara County are doing that, or can do that. 

I think we just don't know. Absence of evidence is not evidence of absence. But I think that it's highly unlikely that the public health officers who were so smart and proactive as to lead the nation in flattening the curve suddenly became so dumb as to not appreciate the need to contact trace all positives and to prepare for a surge in contact tracing, and to not appreciate the consequences of being unable to do that. If they're not ready, I doubt it's from lack of knowledge or effort. Until we actually know what is happening with the ramp-up in capability for contact tracing, I am willing to trust that they are continuing to do a good job. YMMV of course.

I would generally agree that absence of evidence isn't evidence of absence. I have also exchanged emails with the San Mateo County Health Department, where they assured me that they have been contact tracing 100% of the new cases in the county. They also have said that they are thinking about what statistics they will be sharing about their progress, but that they (understandably) don't want to add too much to their workload.

What worries me is that I haven't heard any reports of anybody being placed in quarantine. Given the howls that normally arise from any restriction on freedoms in the US, if they are quarantining people, I would expect to have heard something about it. So, if they are functioning, I would expect that secondary "evidence" to emerge. I would also expect that it would be wise for the County Health Officers to be preparing the people in their jurisdictions for the somewhat intrusive activities of contact tracers. Going from nothing to lots as a step function would seem unwise as a strategy. You would like to use the positive examples of contact tracing to bring the public along as allies, not opponents. They aren't doing that either.

From what I have read, it takes between 5 and 15 people to support contact tracing of 1 case per day, on average. That would mean San Mateo County would need between 150 people and 450 people to operate on their average of say 30 cases per day. They could have hired/transferred that many people without a big external fuss (and therefore no external evidence). I know that was their original expressed intent. However, I still worry about lack of surge capability (which could require many more people) and any known evidence of activity. In particular, I would expect that contact tracing would reveal important information about why San Mateo County has been stuck in a plateau of cases. Do we have a compliance issue with SIP, is it all healthcare workers, or is it injection from other jurisdictions? Is SFO the problem? So while absence of evidence isn't evidence of absence, at some point the "wake turbulence" of effective enforcement should be visible, even in the absence of full public disclosure. That absence worries me.

[Goose]

 Unfortunately, as of now, I see little evidence that San Mateo County, San Francisco County, and Santa Clara County are doing that, or can do that. 

I think we just don't know. Absence of evidence is not evidence of absence. But I think that it's highly unlikely that the public health officers who were so smart and proactive as to lead the nation in flattening the curve suddenly became so dumb as to not appreciate the need to contact trace all positives and to prepare for a surge in contact tracing, and to not appreciate the consequences of being unable to do that. If they're not ready, I doubt it's from lack of knowledge or effort. Until we actually know what is happening with the ramp-up in capability for contact tracing, I am willing to trust that they are continuing to do a good job. YMMV of course.

I would generally agree that absence of evidence isn't evidence of absence. I have also exchanged emails with the San Mateo County Health Department, where they assured me that they have been contact tracing 100% of the new cases in the county. They also have said that they are thinking about what statistics they will be sharing about their progress, but that they (understandably) don't want to add too much to their workload.

What worries me is that I haven't heard any reports of anybody being placed in quarantine. Given the howls that normally arise from any restriction on freedoms in the US, if they are quarantining people, I would expect to have heard something about it. So, if they are functioning, I would expect that secondary "evidence" to emerge. I would also expect that it would be wise for the County Health Officers to be preparing the people in their jurisdictions for the somewhat intrusive activities of contact tracers. Going from nothing to lots as a step function would seem unwise as a strategy. You would like to use the positive examples of contact tracing to bring the public along as allies, not opponents. They aren't doing that either.

From what I have read, it takes between 5 and 15 people to support contact tracing of 1 case per day, on average. That would mean San Mateo County would need between 150 people and 450 people to operate on their average of say 30 cases per day. They could have hired/transferred that many people without a big external fuss (and therefore no external evidence). I know that was their original expressed intent. However, I still worry about lack of surge capability (which could require many more people) and any known evidence of activity. In particular, I would expect that contact tracing would reveal important information about why San Mateo County has been stuck in a plateau of cases. Do we have a compliance issue with SIP, is it all healthcare workers, or is it injection from other jurisdictions? Is SFO the problem? So while absence of evidence isn't evidence of absence, at some point the "wake turbulence" of effective enforcement should be visible, even in the absence of full public disclosure. That absence worries me.