malchior wrote: Tue Mar 03, 2020 10:00 am
Dogstar wrote: Tue Mar 03, 2020 9:33 amThis seems... less than ideal.
This is where I ask someone like Smoove_B what this means. To me, the local and state responses which are good can't act because they have no visibility into the problem. Hopefully there is more that can be done but essentially this person is all on their own. Our government is failing her. Hopefully this gets the attention it deserves because this is heartbreaking *and* frustrating.
Yeah, this is a mess and it's a perfect example of how our systems will get overwhelmed by the worried-well (in this case, the phone line). She's not a worried-well person, but she can't easiyl get the answers she needs.
The core issue is the test kits and the screening definitions. In order to get reimbursed by the feds, the only way the test kits can be used is to test people that meet very specific criteria. What they don't want is for states to just start testing anyone that shows up. I'm pretty sure we have the ability to offer more tests but I suspect months from now there will be follow up articles over how states are being denied reimbursement from the feds for testing and response related to this outbreak. Just call it a hunch. With that, we do need to have some parameters for testing, but I'm genuinely unclear as to why it's so restrictive in Washington state given what we now know (that it's likely been circulating).
What hit my circles yesterday (and I haven't seen it widely reported) is that the CDC site no longer lists the number of tests performed. Instead, they're only showing total cases now on the CDC site. I'm not sure this is a conspiracy yet (it could be related to data management and reporting lag), but it's a pretty big omission from what the weekend reporting looked like and should be clarified or commented in some way. Are they going to issue total testing updates on Wednesday? Fridays? Each Sunday? Having the CDC randomly cancel a meeting with the press yesterday was also not a good look.
I've said it before - everything is on the states and locals right now. The federal government is absolutely failing us, leadership in particular.
EDIT: Another excellent article and a perfect example of how China handled it vs how we're handling
it:
Bruce Aylward - assistant director general and veteran epidemiologist at WHO
Right. [But many still think] it’s a runny nose and cold. Your population is your surveillance system. Everybody has got a smartphone, everybody can get a thermometer. That is your surveillance system. Don’t rely on this hitting your health system, because then it’s going to infect it. You’ve got this great surveillance system out there — make sure the surveillance system is primed. Make sure you’re ready to act on the signals that come in from that surveillance system. You’ve got to be set up to rapidly assess whether or not they really have those symptoms, test those people, and, if necessary, isolate and trace their contacts.
Here, again, is where I’ve seen things starting to break down. What I’ve been told is if you think you’ve been exposed and have a fever, call your [general practitioner]. We’ve got to be better than that. If we are going to use our GPs — do they have an emergency line where you can get through? Do they know what to do?
In China, they have set up a giant network of fever hospitals. In some areas, a team can go to you and swab you and have an answer for you in four to seven hours. But you’ve got to be set up — speed is everything.
So make sure your people know [about the virus]. Make sure you have mechanisms for working with them very quickly through your health system. Then enough public health infrastructure to investigate cases, identify the close contacts, and then make sure they remain under surveillance. That’s 90 percent of the Chinese response.