1/ Covid (@UCSF) Chronicles, Day 21
@UCSFhospitals, 18 Covid+ pts, same. 7 in ICU, 3 on vents. Note: 30 pts @ Zuckerberg SF General Hospital, our safety net, a disproportionate # that likely illustrates emerging Covid disparities, described @voxdotcom bit.ly/39QLdQ4
@UCSFhospitals, 18 Covid+ pts, same. 7 in ICU, 3 on vents. Note: 30 pts @ Zuckerberg SF General Hospital, our safety net, a disproportionate # that likely illustrates emerging Covid disparities, described @voxdotcom bit.ly/39QLdQ4
2/ Of our 9 pts on ventilators @ucsf, 5 have come off, & only 1 has died. We’re not seeing 60-90% mortality for vent’ed pts as in early reports. (Perhaps because we’re not overwhelmed, vs China/Italy.) Other relatively good news: we’ve discharged 18 Covid pts from the hospital.
3/ Another interesting #: @ucsf, we only test pts w/ symptoms, who all think "I have Covid.” But only ~4% of our tests are +, meaning most folks who think they have it, don’t. SF’s rate a bit higher, 13%. Still means only 1/7 people tested – virtually all w/ symptoms – have Covid
4/ SF continues gentle rise, with 622 cases, and 39 new diagnoses. Still only 9 deaths in the entire city since start (Figures). If you had told me any of those figures 3 weeks ago, I would have wondered what you were smoking (it’s SF after all). Amazing, so fortunate here.
5/ Hot spots still hot; NYC will top death #s of 9/11 in next 2 days. Such profound tragedy, there & other affected areas. @GavinNewsom has sent vents from CA to NY, NJ & Illinois – the right move. As typical of @ucsf, many of our folks want to help hard hit areas; decision soon
6/ I spent ~3 hrs today doing press (eg, @KQEDForum: bit.ly/2UPaHcA). Most common questions: a) Has SF (or CA) flattened curve? [Yes] b) What worked? & c) What is next phase of this thing going to be? I’ll focus on (c) for rest of today. Short answer: It’s complicated…
7/ I liked @aaroncarroll’s piece @nytimes nyti.ms/2USmnLB on when we’ll know we’re ready for Phase 2 (it draws heavily on @ScottGolleibMD’s @AEI report bit.ly/2WStSDr). Bottom line: we’ll be ready for next phase when we can pass four key tests (below):
8/ One thing seems clear: Phase 2 will be far more complex than Phase 1. Think about it: once people & policymakers understood the science of viral spread (shockingly, it appears that a few of the latter still don’t), the rules were so simple that a dog could remember them
9/ But the next phase gets far more nuanced & individualized: who gets to go out (work, shopping, school...); how to do surveillance & testing (?virus or antibodies); contact tracing; quarantine (voluntary or mandatory), use of tech (valuable modern tool or too creepy), etc etc…
10/ It’s way too much to fit in a few tweets, so I’ve listed below just a handful of the hard decisions that I’ll be watching for. And this list is only the start, promise.
11/ Key question: how will we use digital in Phase 2. @scottgottliebMD tweets are illuminating bit.ly/2x9TocU. And here’s Science paper re: using tech to analyze community mobility patterns, without compromising pt privacy bit.ly/2yIZJN3 Seems unobjectionable..
12/ But 2nd Science paper bit.ly/2XggucE contemplates more intrusive use of smartphone app for digitally-facilitated contact tracing. And then there's Korea bit.ly/3e3hUgp, where app detects if people under quarantine are violating. Would this be tolerated here?
13/ Of course, no hotter button issue in U.S. politics than personal freedom vs. state power. But what if YOUR freedom puts ME at risk? Like a peeing section in a pool, in a pandemic no person’s (nor state/country’s) behavior can be truly isolated. Lots to chew on.
Tomorrow…
Tomorrow…
