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Local leaders ask: Where are the COVID-19 tests?

Santa Clara County cities call for greater coordination, problem solving

Like many people who are older, Palo Alto City Councilwoman Liz Kniss wanted to get tested for COVID-19. But though she tried, she wasn't eligible for one in Santa Clara County.

She went to one of Stanford Health Care's drive-thru coronavirus-test sites for help.

"I got fairly far. The governor said that (people like me) can get one because of my age, but they indicated that I did not have sufficient symptoms," said Kniss, who is over 60.

So on Wednesday, Kniss drove to Alameda County — to the Hayward COVID-19 Testing Center at California State University, East Bay, which tested her because she is in a high-risk group, regardless of her county of residency. Kniss didn't need an appointment, and the nasal swab procedure took about 20 minutes.

"It was easy," she said of the drive-up procedure. "I'll have the test results tomorrow morning."

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By 9:30 a.m. on Thursday, she had her answer: Her test came back negative.

Kniss apparently is far from alone in leaving Santa Clara County to get assessed for the coronavirus. Another Alameda County city, Fremont, began a drive-thru testing program six weeks ago, spearheaded by the fire chief. As many as 40% of the people tested in Fremont have come from Santa Clara County, according to fire Chief Curtis Jacobson.

As Los Angeles County and, this week, Sacramento County announced coronavirus testing for all of their residents, including those exhibiting no symptoms, Santa Clara County has lagged behind — to the frustration of local leaders like Kniss.

The numbers show the shortfall.

The county needs to be able to test roughly 4,000 people per day before the stay-at-home order can be relaxed, County Executive Jeffrey Smith told the Board of Supervisors on Tuesday, May 5. As of last week, it had reached only about 1,000 tests per day.

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The 4,000 tests per day are the minimum needed; the county's goal is to expand to 15,000 to 20,000 tests per day, he said.

Testing is crucial to getting the county's businesses, schools and other facilities reopened. Without testing, it's hard to identify who has the disease and to whom they are spreading it, Dr. Sara Cody, the county's public health officer, has said.

County Supervisor Joe Simitian voiced his frustration with the slow pace of testing.

"We've only gotten in the last week or so to 1,000 tests. Our current level is 25% of where it needs to be by the end of this month," when the shutdown order ends, he told this news organization.

At Tuesday's meeting, Simitian expressed urgency about testing at all long-term-care facilities, like skilled nursing homes. It's known that the virus has been introduced to residents of these facilities by employees, which highlights the importance of testing asymptomatic individuals, he said.

"This needs to happen now. Forty percent of the deaths are in long-term-care facilities," he said.

Kniss' and Simitian's concerns are widely shared among the county's 15 mayors, who joined together last week to try to spur the county to faster action and greater collaboration with its cities.

In an April 29 letter to county leaders, the mayors specifically requested that the county identify a clear goal "in unambiguous, quantitative terms" for testing frequency that would be sufficient to safely reopen schools and businesses; create a comprehensive list of testing sites; and identify how many people would be needed for contact tracing, the process of identifying — and isolating — people who may have been exposed to someone who tested positive.

The letter noted that Gov. Gavin Newsom's Testing Task Force has asked for partnerships and more testing sites but has not offered specific details. The mayors urged the county to form a county task force devoted to testing.

"Without dramatic scaling of testing from the current levels ... we cannot reopen our county," the letter states.

At the urging of Kniss, Palo Alto's council on May 4 unanimously agreed to hold a full discussion on Monday, May 11, about ways it can help expand testing. Councilman Greg Tanaka noted that Shenzhen, China, which was one of the first cities to experience the pandemic, has been able to reopen about 90% of its economy by offering widespread testing and contact tracing. He also pointed to the free testing run by the cities of Fremont and Hayward.

Testing "lets us know what the spread is," Tanaka said. "And that's what other places have done — Seoul, South Korea, and China. They've been able to reopen successfully and without a resurgence because of this kind of practice."

Yet council members also recognize that the city's ability to offer tests and reopen schools and businesses hinges on the county, given its charge of protecting public health. Mayor Adrian Fine said that anything the city does needs to be "additive to the county process" and not duplicative or counter to what the county is doing. The city would need the county's help to figure out what type of tests to do, how to report results and how to maintain residents' privacy, Fine said.

"We as a city are not professional in those areas," he said.

The problems with testing

County leaders have offered a variety of reasons for why testing in Santa Clara County continues to fall short of the need. On April 29, Smith told the Board of Supervisors' Health and Hospitals Committee that testing is "a priority we have very little control over, locally."

Smith cited the shortage of reagents (chemicals that are used for analysis of samples); the length of time to get approval for tests from the FDA, the CDC and CMS (Centers for Medicare & Medicaid Services); the ineffectiveness of the test developed by the CDC; and the fact that other parts of the nation are doing far worse than Santa Clara County and, as such, are "sucking up the capacity."

Ken Dueker, director of Palo Alto's Office of Emergency Services, similarly attributed the shortage of tests to inadequate supplies of test kits and uneven distribution of personal protective equipment for the health care workers implementing the tests. In some cases, he said, ability to test is limited by a shortage of the required nasopharyngeal swabs.

"Reagents and chemical components have been hit and miss in the supply chain. Even the medium to safely transport the samples has been in short supply," Dueker told the City Council on May 4.

He also noted that while the state has been funneling testing supplies to various parts of California and setting up new testing sites, these resources have not for the most part been directed to Santa Clara County.

"They've gone elsewhere," Dueker said.

All of these reasons do not entirely sit well with the county's supervisors, who instead — like the cities' mayors — point to a lack of coordination as significantly contributing to the problems with testing.

Simitian, who serves on the county's Health and Hospitals Committee, suggested on April 29 that the committee take the lead in coordinating the county's effort to ramp up testing.

"I know for public health purposes that the incremental growth in testing that we've been able to achieve has significance, but in terms of charting a course back (to normal life), these numbers are pretty modest," Simitian said at the meeting. "That's the kindest way I can put it."

Supervisor Susan Ellenberg, who also serves on the committee, agreed.

"There is such discrepancy in what is happening from state to state and from county to county that I fully believe there is more that we could be and must be doing to move this along," Ellenberg said.

That lack of coordination has been evidenced in Kniss' experience of trying to get tested for COVID-19 in her home county — one in which she both worked as a public health nurse and served as a county supervisor. Even as Los Angeles and Sacramento counties have partnered with nonprofit groups to provide COVID-19 tests to all their residents, Santa Clara County's testing network resembles a collection of disparate systems, each with its own rules and objectives.

Most health care systems — Kaiser Permanente, El Camino Health, Palo Alto Medical Foundation — will test only their own patients provided they have symptoms that meet the CDC guidelines and receive a doctor's referral. Stanford Health Care initiated testing with similar restrictions in March, although now the organization allows non-Stanford patients with symptoms or exposure risks to be screened for a possible test. (Stanford Health Care has also focused on testing its 14,000-member workforce and its patients.)

Beyond the private and nonprofit health care networks, there has been no clear route to getting tested unless you fit certain limited criteria. Wonder how you can get tested? Find out through this graphic.

The Palo Alto VA Health Care System is testing military veterans with symptoms. The County Health System is testing those who don't have insurance.

Verily Life Sciences — a research subsidiary of Mountain View's Alphabet — has been testing persons who are either symptomatic or working in frontline professions, such as first responders or health care or prison employees.

And through a new public-private partnership between the state of California and health-services company OptumServe, two sites in south county will offer COVID testing to all, but with the caveat that priority will be given to a range of groups, including high-risk workers, the elderly, the chronically ill, those referred by public health, people living or working in group-care facilities and those with symptoms. Those who are asymptomatic are at the bottom of the list.

Where do we go from here?

Even as local leaders have urged swifter action, the county has made some progress on boosting its testing numbers. And this week, officials announced new plans to ramp up testing capacity and create a new group to improve coordination.

Between April 1 and April 15, the county reported an average of 511 tests per day, according to Public Health Department statistics; in the period between April 16 and May 4, the average number of tests rose to 844; and in the past 10 days, the county reported an average of 1,040 tests per day, with a peak on May 1, when there were 1,383 tests.

The county also formed a new COVID-19 testing task force, to be headed by former county public health officer Dr. Marty Fenstersheib, to move the county toward adequate testing and its longer-term goal of complete contact tracing, which Smith said could require a workforce of 600.

Smith told the Board of Supervisors on May 5 that in order for the county to get closer to testing capacity of 4,000 per day, the tests will come from outside sources.

Stanford Health Care has the capacity to do 2,800 tests per day, Kaiser Permanente 1,500 tests, and Valley Medical Center can 2,000, although it currently can test only 300 a day. It expects to receive new reagent and new machinery at the end of this week.

"We can quickly approach capacity," he said.

Dr. Scott Boyd, associate professor of pathology at Stanford School of Medicine, who created a serology test to identify antibodies to COVID-19 in blood samples, said there are plans to increase the capacity for the PCR swab tests, which identify the virus by its RNA, and the serology test.

Stanford has tested a mix of patients, including some individuals who were asymptomatic, and it has tested samples sent by other medical centers on a small scale. So far, Stanford has had enough supplies for the testing, but shortages have been an ongoing issue in general with tests.

"It's a moving target all of the time," he said.

The county also has loosened its criteria a bit for who can be tested by any organization. Depending on test availability, other health care workers, first responders and essential employees such as grocery clerks, utility workers, food supply workers and others who have close contact with the public can be tested. People who are hospitalized and undergoing elective procedures can also be tested, as can all residents of congregate living facilities, such as senior-care centers. Anyone older than 60 years of age or individuals with chronic medical conditions that increase their risk of severe COVID-19 symptoms can also be tested.

There is now more testing capacity than there are people being tested, Smith said. Private laboratories, including the Verily site, are underutilized. Smith said he has been told people make appointments but don't show up. He said he doesn't know if they have trouble getting to the site or if they aren't being referred there.

Just about everyone agrees that the county's communication on testing has been a problem. When Simitian asked on May 5 whether the county should make the criteria for who can get tests less rigorous, Smith pointed to the recent loosening of the county's guidance and the recent boost in testing capacity.

"Since we currently have capacity for selection, I think for the most part that means anybody," Smith responded. "But that just points out the fact that we're still having trouble communicating that message effectively, because private doctors and institutions aren't necessarily doing it as on call, or as needed."

That said, the official guidelines that are posted on the Santa Clara County website continue to restrict who can get tested, forcing residents to go to other counties. This includes even residents like Kniss, who fit the county's recently expanded criteria. Smith acknowledged this week that the county needs "to communicate that (testing) is available, that it can be done here."

Cody said the challenge is matching the capacity to the need and understanding the barriers to getting people to where they need to be tested.

"We are successful in driving down the infection," she said on May 5 of the nearly 2-month-old public health effort.

In areas where there are more infections, the county needs to do intensive testing and make them priority areas, she said.

"I'm an eternal optimist," Cody said. "I feel we can do this."

Symptoms of COVID-19

The U.S. Centers for Disease Control and Prevention currently lists the common symptoms of COVID-19 as:

• Fever.

• Cough.

• Shortness of breath.

• Chills.

• Muscle pain.

• New loss of taste or smell.

• Vomiting or diarrhea.

• Sore throat.

Editorial Assistant Lloyd Lee contributed to this article.

Find comprehensive coverage of the Midpeninsula's response to the new coronavirus by Palo Alto Online, the Mountain View Voice and the Almanac here.

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Local leaders ask: Where are the COVID-19 tests?

Santa Clara County cities call for greater coordination, problem solving

by / Palo Alto Weekly

Uploaded: Fri, May 8, 2020, 6:41 am

Like many people who are older, Palo Alto City Councilwoman Liz Kniss wanted to get tested for COVID-19. But though she tried, she wasn't eligible for one in Santa Clara County.

She went to one of Stanford Health Care's drive-thru coronavirus-test sites for help.

"I got fairly far. The governor said that (people like me) can get one because of my age, but they indicated that I did not have sufficient symptoms," said Kniss, who is over 60.

So on Wednesday, Kniss drove to Alameda County — to the Hayward COVID-19 Testing Center at California State University, East Bay, which tested her because she is in a high-risk group, regardless of her county of residency. Kniss didn't need an appointment, and the nasal swab procedure took about 20 minutes.

"It was easy," she said of the drive-up procedure. "I'll have the test results tomorrow morning."

By 9:30 a.m. on Thursday, she had her answer: Her test came back negative.

Kniss apparently is far from alone in leaving Santa Clara County to get assessed for the coronavirus. Another Alameda County city, Fremont, began a drive-thru testing program six weeks ago, spearheaded by the fire chief. As many as 40% of the people tested in Fremont have come from Santa Clara County, according to fire Chief Curtis Jacobson.

As Los Angeles County and, this week, Sacramento County announced coronavirus testing for all of their residents, including those exhibiting no symptoms, Santa Clara County has lagged behind — to the frustration of local leaders like Kniss.

The numbers show the shortfall.

The county needs to be able to test roughly 4,000 people per day before the stay-at-home order can be relaxed, County Executive Jeffrey Smith told the Board of Supervisors on Tuesday, May 5. As of last week, it had reached only about 1,000 tests per day.

The 4,000 tests per day are the minimum needed; the county's goal is to expand to 15,000 to 20,000 tests per day, he said.

Testing is crucial to getting the county's businesses, schools and other facilities reopened. Without testing, it's hard to identify who has the disease and to whom they are spreading it, Dr. Sara Cody, the county's public health officer, has said.

County Supervisor Joe Simitian voiced his frustration with the slow pace of testing.

"We've only gotten in the last week or so to 1,000 tests. Our current level is 25% of where it needs to be by the end of this month," when the shutdown order ends, he told this news organization.

At Tuesday's meeting, Simitian expressed urgency about testing at all long-term-care facilities, like skilled nursing homes. It's known that the virus has been introduced to residents of these facilities by employees, which highlights the importance of testing asymptomatic individuals, he said.

"This needs to happen now. Forty percent of the deaths are in long-term-care facilities," he said.

Kniss' and Simitian's concerns are widely shared among the county's 15 mayors, who joined together last week to try to spur the county to faster action and greater collaboration with its cities.

In an April 29 letter to county leaders, the mayors specifically requested that the county identify a clear goal "in unambiguous, quantitative terms" for testing frequency that would be sufficient to safely reopen schools and businesses; create a comprehensive list of testing sites; and identify how many people would be needed for contact tracing, the process of identifying — and isolating — people who may have been exposed to someone who tested positive.

The letter noted that Gov. Gavin Newsom's Testing Task Force has asked for partnerships and more testing sites but has not offered specific details. The mayors urged the county to form a county task force devoted to testing.

"Without dramatic scaling of testing from the current levels ... we cannot reopen our county," the letter states.

At the urging of Kniss, Palo Alto's council on May 4 unanimously agreed to hold a full discussion on Monday, May 11, about ways it can help expand testing. Councilman Greg Tanaka noted that Shenzhen, China, which was one of the first cities to experience the pandemic, has been able to reopen about 90% of its economy by offering widespread testing and contact tracing. He also pointed to the free testing run by the cities of Fremont and Hayward.

Testing "lets us know what the spread is," Tanaka said. "And that's what other places have done — Seoul, South Korea, and China. They've been able to reopen successfully and without a resurgence because of this kind of practice."

Yet council members also recognize that the city's ability to offer tests and reopen schools and businesses hinges on the county, given its charge of protecting public health. Mayor Adrian Fine said that anything the city does needs to be "additive to the county process" and not duplicative or counter to what the county is doing. The city would need the county's help to figure out what type of tests to do, how to report results and how to maintain residents' privacy, Fine said.

"We as a city are not professional in those areas," he said.

The problems with testing

County leaders have offered a variety of reasons for why testing in Santa Clara County continues to fall short of the need. On April 29, Smith told the Board of Supervisors' Health and Hospitals Committee that testing is "a priority we have very little control over, locally."

Smith cited the shortage of reagents (chemicals that are used for analysis of samples); the length of time to get approval for tests from the FDA, the CDC and CMS (Centers for Medicare & Medicaid Services); the ineffectiveness of the test developed by the CDC; and the fact that other parts of the nation are doing far worse than Santa Clara County and, as such, are "sucking up the capacity."

Ken Dueker, director of Palo Alto's Office of Emergency Services, similarly attributed the shortage of tests to inadequate supplies of test kits and uneven distribution of personal protective equipment for the health care workers implementing the tests. In some cases, he said, ability to test is limited by a shortage of the required nasopharyngeal swabs.

"Reagents and chemical components have been hit and miss in the supply chain. Even the medium to safely transport the samples has been in short supply," Dueker told the City Council on May 4.

He also noted that while the state has been funneling testing supplies to various parts of California and setting up new testing sites, these resources have not for the most part been directed to Santa Clara County.

"They've gone elsewhere," Dueker said.

All of these reasons do not entirely sit well with the county's supervisors, who instead — like the cities' mayors — point to a lack of coordination as significantly contributing to the problems with testing.

Simitian, who serves on the county's Health and Hospitals Committee, suggested on April 29 that the committee take the lead in coordinating the county's effort to ramp up testing.

"I know for public health purposes that the incremental growth in testing that we've been able to achieve has significance, but in terms of charting a course back (to normal life), these numbers are pretty modest," Simitian said at the meeting. "That's the kindest way I can put it."

Supervisor Susan Ellenberg, who also serves on the committee, agreed.

"There is such discrepancy in what is happening from state to state and from county to county that I fully believe there is more that we could be and must be doing to move this along," Ellenberg said.

That lack of coordination has been evidenced in Kniss' experience of trying to get tested for COVID-19 in her home county — one in which she both worked as a public health nurse and served as a county supervisor. Even as Los Angeles and Sacramento counties have partnered with nonprofit groups to provide COVID-19 tests to all their residents, Santa Clara County's testing network resembles a collection of disparate systems, each with its own rules and objectives.

Most health care systems — Kaiser Permanente, El Camino Health, Palo Alto Medical Foundation — will test only their own patients provided they have symptoms that meet the CDC guidelines and receive a doctor's referral. Stanford Health Care initiated testing with similar restrictions in March, although now the organization allows non-Stanford patients with symptoms or exposure risks to be screened for a possible test. (Stanford Health Care has also focused on testing its 14,000-member workforce and its patients.)

Beyond the private and nonprofit health care networks, there has been no clear route to getting tested unless you fit certain limited criteria. Wonder how you can get tested? Find out through this graphic.

The Palo Alto VA Health Care System is testing military veterans with symptoms. The County Health System is testing those who don't have insurance.

Verily Life Sciences — a research subsidiary of Mountain View's Alphabet — has been testing persons who are either symptomatic or working in frontline professions, such as first responders or health care or prison employees.

And through a new public-private partnership between the state of California and health-services company OptumServe, two sites in south county will offer COVID testing to all, but with the caveat that priority will be given to a range of groups, including high-risk workers, the elderly, the chronically ill, those referred by public health, people living or working in group-care facilities and those with symptoms. Those who are asymptomatic are at the bottom of the list.

Where do we go from here?

Even as local leaders have urged swifter action, the county has made some progress on boosting its testing numbers. And this week, officials announced new plans to ramp up testing capacity and create a new group to improve coordination.

Between April 1 and April 15, the county reported an average of 511 tests per day, according to Public Health Department statistics; in the period between April 16 and May 4, the average number of tests rose to 844; and in the past 10 days, the county reported an average of 1,040 tests per day, with a peak on May 1, when there were 1,383 tests.

The county also formed a new COVID-19 testing task force, to be headed by former county public health officer Dr. Marty Fenstersheib, to move the county toward adequate testing and its longer-term goal of complete contact tracing, which Smith said could require a workforce of 600.

Smith told the Board of Supervisors on May 5 that in order for the county to get closer to testing capacity of 4,000 per day, the tests will come from outside sources.

Stanford Health Care has the capacity to do 2,800 tests per day, Kaiser Permanente 1,500 tests, and Valley Medical Center can 2,000, although it currently can test only 300 a day. It expects to receive new reagent and new machinery at the end of this week.

"We can quickly approach capacity," he said.

Dr. Scott Boyd, associate professor of pathology at Stanford School of Medicine, who created a serology test to identify antibodies to COVID-19 in blood samples, said there are plans to increase the capacity for the PCR swab tests, which identify the virus by its RNA, and the serology test.

Stanford has tested a mix of patients, including some individuals who were asymptomatic, and it has tested samples sent by other medical centers on a small scale. So far, Stanford has had enough supplies for the testing, but shortages have been an ongoing issue in general with tests.

"It's a moving target all of the time," he said.

The county also has loosened its criteria a bit for who can be tested by any organization. Depending on test availability, other health care workers, first responders and essential employees such as grocery clerks, utility workers, food supply workers and others who have close contact with the public can be tested. People who are hospitalized and undergoing elective procedures can also be tested, as can all residents of congregate living facilities, such as senior-care centers. Anyone older than 60 years of age or individuals with chronic medical conditions that increase their risk of severe COVID-19 symptoms can also be tested.

There is now more testing capacity than there are people being tested, Smith said. Private laboratories, including the Verily site, are underutilized. Smith said he has been told people make appointments but don't show up. He said he doesn't know if they have trouble getting to the site or if they aren't being referred there.

Just about everyone agrees that the county's communication on testing has been a problem. When Simitian asked on May 5 whether the county should make the criteria for who can get tests less rigorous, Smith pointed to the recent loosening of the county's guidance and the recent boost in testing capacity.

"Since we currently have capacity for selection, I think for the most part that means anybody," Smith responded. "But that just points out the fact that we're still having trouble communicating that message effectively, because private doctors and institutions aren't necessarily doing it as on call, or as needed."

That said, the official guidelines that are posted on the Santa Clara County website continue to restrict who can get tested, forcing residents to go to other counties. This includes even residents like Kniss, who fit the county's recently expanded criteria. Smith acknowledged this week that the county needs "to communicate that (testing) is available, that it can be done here."

Cody said the challenge is matching the capacity to the need and understanding the barriers to getting people to where they need to be tested.

"We are successful in driving down the infection," she said on May 5 of the nearly 2-month-old public health effort.

In areas where there are more infections, the county needs to do intensive testing and make them priority areas, she said.

"I'm an eternal optimist," Cody said. "I feel we can do this."

Symptoms of COVID-19

The U.S. Centers for Disease Control and Prevention currently lists the common symptoms of COVID-19 as:

• Fever.

• Cough.

• Shortness of breath.

• Chills.

• Muscle pain.

• New loss of taste or smell.

• Vomiting or diarrhea.

• Sore throat.

Editorial Assistant Lloyd Lee contributed to this article.

Find comprehensive coverage of the Midpeninsula's response to the new coronavirus by Palo Alto Online, the Mountain View Voice and the Almanac here.

Comments

resident
Midtown
on May 8, 2020 at 8:51 am
resident, Midtown
on May 8, 2020 at 8:51 am

The governor has set guidelines for reopening the economy in California counties. Two of the primary metrics are testing levels and test results. Right now, Santa Clara County is far below the testing level we need to reopen the economy. No matter whose fault this is, we need to fix this right now.


midtown2
Midtown
on May 8, 2020 at 9:01 am
midtown2, Midtown
on May 8, 2020 at 9:01 am

Hoping someone can explain how it is any comfort to have a diagnostic test that turns out negative. Don't we think that the very next day we could be infected? Certainly I am missing something - look forward to an explanation.


m2grs
Midtown
on May 8, 2020 at 10:46 am
m2grs, Midtown
on May 8, 2020 at 10:46 am

Simple. This country no longer has the manufacturing capability to mass-produce stuff, such as chemicals, swabs, specialty papers, etc. for testing.

Even if there is a good technology, great invention, we look to other countries such as China to make it. From iPhone to Penicillin, from Nike shoes to face masks.

Wall Street has hollowed out this country for decades in search for profit. Liberals made it much worse by always being cynical about local factory "working conditions" and inciting worker rebellions.


Bob Gleason
Old Palo Alto
on May 8, 2020 at 10:48 am
Bob Gleason, Old Palo Alto
on May 8, 2020 at 10:48 am

We live in the most innovative county in the Bay Area. Home of the most success and leading edge companies on the planet. It is embarrassing that after 9 weeks of shutdown that this lack of testing excuse continues to come up. Stop pointing fingers and put together a specific action plan with a specific target date to eliminate this lack of testing problem. Come on leaders.. this is not that hard of a problem to resolve.. Unless of course the "lack of testing" is a convenient excuse to keep things shutdown.


Downfall
Fairmeadow
on May 8, 2020 at 10:57 am
Downfall, Fairmeadow
on May 8, 2020 at 10:57 am

Looks like county leadership has been too busy patting themselves on the back for the relatively early shutdown order and addressing non-essential issues like getting gardeners and construction crews back to work instead of getting us all the testing needed to help bring everyone out of lockdown.


Joyce
Stanford
on May 8, 2020 at 11:11 am
Joyce, Stanford
on May 8, 2020 at 11:11 am

Many people would like to know if they had the virus. The recent study testing for Covid 19 antibodies in Santa Clara (conducted by scientists at Stanford) has been fairly criticized by peer-review for the assumptions the investigators made about the accuracy of tests, as well as sampling bias.
The serology tests used in this study were obtained from a US company that distributes home test kits from China. There are several companies in the US that have been granted distribution rights by the FDA to distribute these tests in the US, and there are several companies in China manufacturing the tests. Some tests have higher accuracy than others. None are 100% accurate, as the Stanford study assumed. If someone told you that the test indicated you had Covid19 virus antibodies with 85% accuracy, how would that change your behavior? What if it was 90% accurate? I fear that most people would not hear the bit about accuracy and act as if they were immune. If this is the case, what is the risk to the public? Let's evaluate how this risk depends on test accuracy.


Wake up
Mountain View
on May 8, 2020 at 11:12 am
Wake up, Mountain View
on May 8, 2020 at 11:12 am

Finally, it appears people are starting to wake up! Frightening that it’s taken so long but glad to see it happen.


Clara Drivers
Midtown
on May 8, 2020 at 11:14 am
Clara Drivers, Midtown
on May 8, 2020 at 11:14 am

This is all wrong. We are already testing enough people in this county (too many, actually). The reason to do more testing is to drive the positive rate low enough to ensure that we are catching all or most people who have the virus, so we can isolate them and find their contacts and isolate those people. The WHO recommends a positive rate <10%. South Korea and Taiwan, who have done an amazing job at testing and contact tracing, are at about a 3% positive test rate. Santa Clara County is now BELOW 1%. On May 6th, there were 3 positive results out of 1262 tested, or a 0.2% positive rate. The day before that, there were 8 positive results out of 1193 tested, or 0.7%. The rate is dropping every day, yet we still talk of needing to test 4,000 or even more people each day before we realize that the hammer has worked in our county, and now we need to teach this state and this country how to dance! I'm appalled at other states who are opening up too soon, with cases per day still growing and positive test rates well over 10%, which will no doubt lead to more spread. But this is not the situation here in Santa Clara County, and we are wasting a golden opportunity to take the lead on this and show other counties and states how to slowly open up the economy the right way.


Dan
Professorville
on May 8, 2020 at 11:20 am
Dan, Professorville
on May 8, 2020 at 11:20 am

It would seem that at this point that our local political leaders need to step in and start making some hard decisions. So far they have seemed content to let Dr. Cody, our public health officer, set policy.

But Dr. Cody is narrowly responsible for public health. We expect our local leaders to take into account the entire picture - including the damage done by our public health policies. The hard reality is that they will have to achieve a balance between public health perfection and the real and long lasting damage caused by shelter in place.

Setting an unattainable testing goal as a gating criteria for starting to safely and thoughtfully open our economy, with no plan as to how to achieve that goal or timeline to achieve it, is a great example. That policy only has the public health lens in mind - there is no backpressure on it based on economic and other damage being done in the meantime.

I'd expect our political leaders to recognize this dilemma, and put in place a mitigation strategy - of course they need to put in place policies to accellerate development of testing, but they also need to look at alternative strategies that maintain public health as much as possible given the short or even medium term reality of that we aren't going to have enought tests for a while.

That is going to take actual leadership, and making hard trade-offs. I think this is what we elect them for...



NeilsonBuchanan
Downtown North
on May 8, 2020 at 11:24 am
NeilsonBuchanan, Downtown North
on May 8, 2020 at 11:24 am

Our priorities seem confused. I am in high risk group based on my age, lungs, one beloved kidney, medical history...however, I have done my research on the practical limitations of testing "everyone".

I manage my risks with very limited and very calculated time outside my home. This means no contact with friends and family who are only a few blocks away.

Bottom line: Testing has very real limitations to serve everyone now and for the foreseeable future. Equipment, reagents, etc are in short supply. I could be tested now but there is very little value to me. Many more people have much higher priority.

I trust city and county officials to access testing capacity at warp, practical speed and then allocate testing to the highest priority citizens and workers.


T
Mountain View
on May 8, 2020 at 11:33 am
T, Mountain View
on May 8, 2020 at 11:33 am

Santa Clara is being too defensive about reopening. Sara Cody needs a wake up call.. while they did good work closing quickly, they just seem to be sitting back after that rather than working towards reopening.
Being shut down the way we are is going to make things worse from this point. Please work towards reopening and take a more positive tone than being scared of 2nd wave.
People are already running out of patience and after a certain point, shelter at home orders won't matter. March 15th to May 31st is already 76 days of lockdown which is equivalent to Wuhan.
But neither is it strict enough nor effective except its killing people's business


westridge7
Portola Valley
on May 8, 2020 at 11:42 am
westridge7, Portola Valley
on May 8, 2020 at 11:42 am

Sheer unacceptable incompetence by county leadership across the board. We live in Silicon Valley - supposedly the epicenter of entrepreneurial capitalism - but can't manage to offer a fraction of the tests parts of California (never mind the nation) we probably see as far more "backward" have been managing for weeks. In corporate America, people get removed from their jobs for inpetitude of this level, as they should with an issue of this magnitude. Whether or not they continue to keep all their employees working from home through December 31, Facebook, Google, Microsoft, etc., should assign a couple of their best/brightest to get this straightened out in the next 10 days and get San Mateo and Santa Clara functional again. I'd owe them a debt of gratitude if they did.


m2grs
Midtown
on May 8, 2020 at 12:12 pm
m2grs, Midtown
on May 8, 2020 at 12:12 pm

@Clara Drivers, what you said works in normal situations. But this is not normal. Excessive testing, if you will, is needed so people and employers can have a peace of mind. This is about social psychology.

For example, I would not want the cleaning ladies who used to come every week before COVID19 to resume her service unless they have and can be tested regularly, no matter how low risk statistics will say.


Mike W
Adobe-Meadow
on May 8, 2020 at 12:19 pm
Mike W, Adobe-Meadow
on May 8, 2020 at 12:19 pm

1,900,000 live in Santa Clara County, 127 have died and 2,200 have been diagnosed. There is no need for testing and no need to shut down the economy. [Portion removed.]


Mike W
Adobe-Meadow
on May 8, 2020 at 12:22 pm
Mike W, Adobe-Meadow
on May 8, 2020 at 12:22 pm

m2grs you are entitled! you have more risk of dieing from a heart attack or driving to work if you still work!


A Sane Person
College Terrace
on May 8, 2020 at 12:27 pm
A Sane Person, College Terrace
on May 8, 2020 at 12:27 pm

This is madness. And this article is not helpful. Kniss's plight doesn't show our county's lack of testing capacity, it shows that our county has overly restrictive test eligibility requirements. Our county test positivity rate is under 1%. Most immunologists will tell you that a number that low is a sign of over testing. The reason we don't have the number of "required" tests is because people are not symptomatic. We will never reach that testing goal because we don't have enough symptomatic people. The data on the county's own website show all this. Dr. Cody needs an intervention.


Turn off fox 'news' , , ,
Crescent Park
on May 8, 2020 at 12:32 pm
Turn off fox 'news' , , , , Crescent Park
on May 8, 2020 at 12:32 pm

- Certainly I am missing something

Yes, you are. Try googling the CDC or Dr Fauci. Look at Singapore, South Korea or Germany.

Turn off Fox.


John
Professorville
on May 8, 2020 at 1:14 pm
John, Professorville
on May 8, 2020 at 1:14 pm

Who elected Sara Cody, and why is she driving all government policy through her very narrow lens?

There has been plenty of testing, and the data clearly and consistently shows a very low infection and spread rate. it is one of the lowest of any urban area in the US. That should be enough to at least try some opening strategies.

Even if you believe that more testing is necessary, it is unconscionable that after 11 weeks there is still no plan in place for testing. You can walk into Quest diagnostics right now and get an antibody test, it takes 5 minutes and returns the results overnight.

Instead of hiring and training armies of "contract tracers" -- great, more bureaucracy -- why not use that money to pay Stanford, Quest, and others to ramp up tests?

By the way, Santa Clara is the 5th wealthiest county in America, so don't tell me we don't have the resources. It's about Sara Cody setting an impossible goal of "zero cases, zero spread". How about another victory lap?



Messifan
Ventura
on May 8, 2020 at 1:14 pm
Messifan, Ventura
on May 8, 2020 at 1:14 pm

I wish someone in power would question the need for 4000 tests. I believe that was something from a paper by a group from Harvard, but I can't find it. There is nothing magical about that 4000 number. There is no evidence that SCC is somehow short of testing. With the current testing numbers go down every day as we are now at 111 hospitalizations. Further, with so few with sick, how do we get to 4000? The test is unpleasant and puts one in a medical setting. Maybe Liz Kniss wants a test, but most people don't.

The same goes for tracing. I read in the Merc that we can currently trace 75 people per day in SCC. The covid dashboard lists only 11 new cases today. We are already in a fine position for tracing.

I don't see any justification for not moving into stage 2 of reopening with the state.


Be accurate
Charleston Gardens
on May 8, 2020 at 1:20 pm
Be accurate, Charleston Gardens
on May 8, 2020 at 1:20 pm

Funny ...
There are four other counties within an hour drive. There are people crossing two or three county borders during their daily commute. Santa Clara is not an island like Singapore, or semi-island, like S Korea, and for sure not as disciplined as those countries.
The Bay Area has to be taken as a whole. Talk about waking up ...


Anon
Another Palo Alto neighborhood
on May 8, 2020 at 1:44 pm
Anon, Another Palo Alto neighborhood
on May 8, 2020 at 1:44 pm

Posted by NeilsonBuchanan, a resident of Downtown North

>> Our priorities seem confused. I am in high risk group based on my age, lungs, one beloved kidney, medical history... [...] I manage my risks with very limited and very calculated time outside my home. This means no contact with friends and family who are only a few blocks away.

It could be very useful to you to know that certain family (or friends) that you -must- have some contact with have high levels of antibodies (with high probability) but are not active carriers. I'm just saying that identifying people who are extremely low risk to transmit to you could be very useful. (I am *not* saying that this testing capability is available yet.)

Posted by T, a resident of Mountain View

>> Santa Clara is being too defensive about reopening.

Evidence?

>> Being shut down the way we are is going to make things worse from this point. Please work towards reopening

Reopening *what*? Construction has restarted, some outdoor jobs, most software dev. and many/most office jobs have been working all along if many/most can work remotely. The question now is what non-essential commercial establishments can reopen, and, how they can reopen safely.

>> and take a more positive tone than being scared of 2nd wave.

Please do some more research. If you are thinking restaurants/bars/etc, from everything known right now, that would be a bad idea. I feel sorry for sit-down restaurant owners and the employees, but, most of their establishments cannot be responsibly reopened right now-- the probability of virus transmission is too high. The virus just replicates and transmits-- it doesn't care about your optimism or positive tone.


Clara Drivers
Midtown
on May 8, 2020 at 2:01 pm
Clara Drivers, Midtown
on May 8, 2020 at 2:01 pm

@A Sane Person - you are absolutely correct.

@Messifan - the 4000 number is likely derived from the Harvard study recommending 150 tests per day per 100,000 people, which across the country is probably a good average. That number is based on testing enough people to catch those infected and isolate them and their contacts. But the actual number we need to test locally depends on the positive rate locally - if the rate is already very low, as it is now in SCC, we are already testing enough.

@m2grs - I appreciate your viewpoint, but there's no way the county is going to pay to test every employee of every service provider weekly. That would be well north of 4000 tests per day in a county of 2 million people. Dr. Cody's push for increased testing doesn't derive from social psychology, it's based on a previously established goal that did make sense when we were seeing 70-80 cases per day in SCC.


T
Mountain View
on May 8, 2020 at 2:06 pm
T, Mountain View
on May 8, 2020 at 2:06 pm

@Anon, please keep your assumptions to yourself about my research.
I understand the need for physical distancing and mitigating the spread of virus.
I am not referring to restaurants and bars but a multitude of other things considered "non-essential" and being shut down causing historic unemployment.

The truth is, there is lot more data available about how serious this virus is and how it disproportionately kill older people with comorbidities.

Also, another truth is that curve flattened in bay area almost 3 week back. All surge capacity beds are empty and hospitals in santa clara don't even have 15% capacity filled with COVID-19 patients. All this data is available on SC county dashboard.

I am not against being careful and I am not saying lets open everything. I have saying we need a better plan rather than this big hammer of keeping everyone at home.

The reason I say too defensive is because despite new infection rate "dropping" for several weeks, Sara Cody doesn't seem to show any signs of urgency in "moving forward".

I read atleast one research paper relevant to COVID-19 everyday and the general consensus is that outdoor transmission is comparatively less. Why can't people be allowed to go to beaches then if they can maintain distance? This is just one of the examples of unnecessary restrictions specially on less vulnerable people.

Out of the top 100 clusters of coronavirus, around 90% are care homes/meat processing plants/prisons.

The stanford study and other similar studies done in NY tell us that infection is much widespread than we initially thought. There can be debates about exactly how widespread based on accuracy of tests but we know for certain they are much more widespread than being currently reported. What that means is mortality rate is lower. So, rather than taking this positive, Sara Cody goes on to say that "this means there are many more people waiting to infect others". Sure that's another way to look at it but rather highlight both sides and accept mortality is lower and this isn't as dangerous as was initially thought.

Despite all of the data about 1. widespread infections 2. flattened curve 3. empty hospitals 4. known clusters of infections etc. there are some people who continue to parrot the fear mongering negative tone with regards to coronavirus rather than trying to move forward logically and in a balanced way.

To add to that, people's health is also getting impacted by SIP. So its not just economic and SIP is not going to make us healthier. We need a more balanced selective approach rather than this BIG HAMMER of SIP


T
Mountain View
on May 8, 2020 at 2:14 pm
T, Mountain View
on May 8, 2020 at 2:14 pm

Sara Cody needs to be woken up! Its time to move forward.
I am not saying open everything suddenly, but we need to move forward and loosen restrictions
For why I think so, please see my earlier comment


Clara Drivers
Midtown
on May 8, 2020 at 2:18 pm
Clara Drivers, Midtown
on May 8, 2020 at 2:18 pm

@Be accurate - you make a good point that we should look at surrounding counties and not just SCC when making these decisions. And you are correct in assuming that some nearby counties aren't doing as well as SCC - San Mateo and San Francisco counties, for example, still have positive testing rates of 5-7% and daily case rates per capita higher than SCC. That means those counties should probably be doing more testing and may not be quite as ready as SCC to move to Phase 2. But to suggest that the entire bay area needs to be in as good a shape as SCC for any county to take small steps seems overly conservative.

I realize we cannot control our borders with neighboring counties - perhaps we should be sharing some of SCC's extra tests with them to help them achieve the same level of success we have had here.


[email protected]
Old Palo Alto
on May 8, 2020 at 2:19 pm
[email protected], Old Palo Alto
on May 8, 2020 at 2:19 pm

My husband and I have been going to Dignity Health for Covad testing. They will test you for the virus with a nose swab using the Abbott Labs test. We received a postcard on this.

They will also test you for antibodies, specifically the IgG antibody using the ELISA test. Go to this website and sign up for a virtual visit to start the process.

Web Link

Medicare pays for this at no cost to us. You do not need to be symptomatic.

Monty and Judy Frost


Dave E
Midtown
on May 8, 2020 at 2:28 pm
Dave E, Midtown
on May 8, 2020 at 2:28 pm

OK then, I think Liz just lost my vote. She insists on being tested even though she has no symptoms of an infection and drives out of town, violating the stay at home order to do it. Potentially making it harder for people in Hayward that really need a test to get it. All to get a test result that says yesterday you weren't sick. Does she know what the RT-PCR test means? Brilliant. Entitled much?


data ANALysis, paralysis, obfuscation
Midtown
on May 8, 2020 at 2:49 pm
data ANALysis, paralysis, obfuscation, Midtown
on May 8, 2020 at 2:49 pm

Not all COVID19 tests are the same. Only the PCR tests is reliable but
it could take days to get the results. The "Emergency Use Authorization"
rapid tests are not yet proven to be reliable.
The media and academic community are slowly waking up and pointing
those out after politicians started to "open" up, and people in
high places were found COVID19 positive suddenly.

The leaders thought throwing money at the problem would solve everything.
Just sat back, kept complaining, promising "it is coming, it is coming",
accepting thanks for what people did by staying at home while they
did half-ass job, still not getting things ready in place!


Don't-Test-Me--Test-The-Man-Behind-The-Tree
Another Palo Alto neighborhood
on May 8, 2020 at 2:53 pm
Don't-Test-Me--Test-The-Man-Behind-The-Tree, Another Palo Alto neighborhood
on May 8, 2020 at 2:53 pm

The following tables provide some insight into what it would take in terms of time to test the nation at least once, using existing test technologies, assuming that a test could be completed in a day--

Tests Time to Test
per day Nation (Months)
--------- ----
200000 55
300000 37
400000 28
500000 22
600000 18
700000 16
1000000 11
1100000 10
1200000 9
1300000 8


And if the testing really increases--

Time to
Tests Test Nation
per day (Months)
------- ----
500,000 22
1,000,000 11
2,000,000 6
3,000,000 4
4,000,000 3

These numbers don’t consider the costs—which could easily run to $30+-50+B (or more) each time a complete testing of the nation is required.

Without a paradigm shift in testing technology, and a national registry of people who have been tested—then all of this testing will not necessarily provide much in the way of controlling the pandemic.

There are a lot of people in this country who probably will not willingly volunteer to be tested. Will the various Federal/State/Local governments end up mandating testing—with failure to comply ending up in forced testing and/or incarceration?


midtown2
Midtown
on May 8, 2020 at 3:11 pm
midtown2, Midtown
on May 8, 2020 at 3:11 pm

to Turn Off Fox News - I don't have radio or tv, barely have internet. I hope Liz Kniss, then, will let me know why she found it reassuring to have a negative diagnostic test. To me that just means she did not have it at the moment of testing. Does not mean that she might get infected the next day. If I am wrong, please don't direct me to other sites. If I am wrong, I could get the answer, I think, in one sentence.


midtown2
Midtown
on May 8, 2020 at 3:14 pm
midtown2, Midtown
on May 8, 2020 at 3:14 pm

to Turn Off Fox News - corrected version I don't have radio or tv, barely have internet. I hope Liz Kniss, then, will let me know why she found it reassuring to have a negative diagnostic test. To me that just means she did not have it at the moment of testing. Does not mean that she might not get infected the next day. If I am wrong, please don't direct me to other sites. If I am wrong, I could get the answer, I think, in one sentence.


S_mom
Community Center
on May 8, 2020 at 3:34 pm
S_mom, Community Center
on May 8, 2020 at 3:34 pm

Thank you T and Clara Drivers (and others in support). When you step back and look at our current numbers as well as the unprecedented restrictions and harm the SIP is causing, staying as we are does not make sense anymore! I am not spouting some Fox News opinion that we should never curtail any freedoms, but just that we cannot justify the current restrictions any longer with the current level of Covid risk. Setting an impossible goal of testing per day (which as others have pointed out much more eloquently than me, becomes more and more difficult the lower our numbers get -- where are we going to find symptomatic people to test? How many people have even gotten so much as a simple cold while staying at home for weeks?) makes it look like our officials aren't giving sufficient weight to the downsides of sheltering in place.

I would hope that public health officials would be the exact people qualified to weigh the risks of Covid against the societal harms of sheltering at this level, but I'm a little worried that maybe someone trained as a doctor is inclined to fear the possibility of any deaths and can't fairly evaluate that possibility against the huge societal harm we are doing (justified at first, not justified at this point). Look at the news about rising food insecurity and overwhelmed food banks, so many people are hurting right now. These are very difficult decisions but our officials need to have the courage to make changes, even though of course any change they make could be eventually be criticized. Fear of criticism from making changes probably is what is driving their slow response -- remember when they were reluctant to close schools at first, who wants to bet they'll also be quite reluctant to reopen them (not at all saying we should reopen now, just pointing out that I think our officials are overly biased toward maintaining the status quo, even when the status quo is extreme). Every decision they make inevitably hurts some people and helps others...I don't envy their position but do think they are making the wrong choice right now. We should be in phase 2 next week.


Minister of Silly Walks
Stanford
on May 8, 2020 at 4:06 pm
Minister of Silly Walks, Stanford
on May 8, 2020 at 4:06 pm

This whole thing is devolving into some Monty-Python-Orwellian nightmare...
HEALTH MINISTER: We cannot open unless you bring me 4,000 tests per day!
CITIZEN: Okay, can I get tested?
HM: Do you have any symptoms?
CITIZEN: No.
HM: No test for you!
CITIZEN: Well, if hardly anyone is having any symptoms, which by the way isn't at all surprising since less than 0.2% of county tests are positive, how are we supposed to bring you your 4,000 tests per day?
HM: Then we will have no choice but to wait until enough people get symptomatic so we reach our magic number.
CITIZEN: But we've all been stuck at home for two months. How are we going to get sick?
HM: Mission accomplished.


Wake up!
Mountain View
on May 8, 2020 at 4:20 pm
Wake up!, Mountain View
on May 8, 2020 at 4:20 pm

Hallelujah it appears people are finally waking up!

I have just one thing to say and honest to god I cannot believe I am even having to make this statement but it is specific to m2grs comment ‘I would not want the cleaning ladies who used to come every week before COVID19 to resume her service unless they have and can be tested regularly, no matter how low risk statistics will say’.

Maybe, just maybe, you will have to suffer up and clean your house yourself until this is all worked out. If you are unable to clean your house I am truly sorry, these are tough times for many. Lot of people have no income, no jobs, can’t pay rent or purchase groceries.


John
Professorville
on May 8, 2020 at 4:31 pm
John, Professorville
on May 8, 2020 at 4:31 pm

Dr. Cody and health officials are making mono-channel decisions based on an impossible standard of “zero deaths and zero cases”. This is complete fantasy.

The politicians are making reactive decisions to show they are “doing something” and “trusting science”. It’s a race to prove they are the anti-Trump.

But that doesn’t mean the decisions are correct. In fact many of them appear to fly in the face of logic and actual observed data.

Who loses? All of us.


TimR
Downtown North
on May 8, 2020 at 5:01 pm
TimR, Downtown North
on May 8, 2020 at 5:01 pm

Sitting back and letting Dr. Cody say shut everything down and keep it shut down is the easy part. But the time has come for the county's politicians to take it from here, and get some actual work done (which some are starting to do). They can fiddle no longer while Rome burns.


senor blogger
Palo Verde
on May 8, 2020 at 5:04 pm
senor blogger, Palo Verde
on May 8, 2020 at 5:04 pm

Why is Kniss trying to get tested if she has no symptoms?
She is just taking a test from someone who has symptoms.
Why is trump getting rested every day.
This is stupid.


Anonymous
Duveneck/St. Francis
on May 8, 2020 at 5:26 pm
Anonymous, Duveneck/St. Francis
on May 8, 2020 at 5:26 pm

We need more tests. Santa Clara County is a wealthy county. If there’s no budget, then they are incompetent or have too high of a costly payroll.
Smug local politicians in Santa Clara County (and Palo Alto) should NOT get to leap the line as they drive to another county.
Where is MY test?


chris
University South
on May 8, 2020 at 8:47 pm
chris, University South
on May 8, 2020 at 8:47 pm

Too many people debating testing, which misses the point.

Testing is not meaningful without tracing and quarantining. SCC is in the process of hiring and training 600 tracers.

These people are needed to follow up on all the contacts of the infected and isolate and repeatedly test those contacts.

If a robust process is not set up to handle this, we will be back to where we were in February, when a few cases exploded into a full scale pandemic while everybody in the US sat on their thumbs.

It is unfortunate that Palo Alto has so many amateur epidemiologists who think they know more than Sara Cody.
Look at what countries that are serious snout it are doing. Anybody coming into Taiwan is placed into an enforced 14-day quarantine. In Hong Kong, they place an electronic bracelet on people to link them to their phone. These countries have recent experiences with epidemics. American tend to be incredibly naive and arrogant.


John
Professorville
on May 8, 2020 at 9:15 pm
John, Professorville
on May 8, 2020 at 9:15 pm

Chris,

You say that “SCC is hiring 600 tracers.” Ok, really? How long will that take? Weeks? Months? And what about training? Who are they hiring? What hasn’t the esteemed Dr. Cody provided any update on timeline? Because she is operating in a narrow mindset, with no sense of urgency other than wagging their fingers at us like we are children.

By the way, couldn’t we try a few other strategies while we wait for the army of tracers to magically appear? Is that really the only tool at our disposal? I doubt it.

As for your derisive comments about us being amateur epidemiologists - I don’t think anyone here is claiming to have the same credentials as Dr. Cody. But we are looking at the same data as her, and it is completely illogical to sit around for all this time, without a plan and without taking into the account the larger risks our inaction is causing.

It is just common sense, so please stop belittling those who exercise it.


TimR
Downtown North
on May 8, 2020 at 9:33 pm
TimR, Downtown North
on May 8, 2020 at 9:33 pm

@John,
"You say that 'SCC is hiring 600 tracers.' Ok, really? How long will that take? Weeks? Months? And what about training? Who are they hiring?"

I would add, and how are they dealing with the language issues? The SCC Dashboard alone is in English, Spanish, Vietnamese, Chinese and Tagalog (and our voting ballots come in even more). If those languages are needed for the Dashboard, I assume different languages will be needed for the contact tracing process, too. Because as we keep hearing in the news, "minority" communities are the hardest hit by the virus, and will therefore need the most contact tracing. Given how government works, all that will take months to put in place.


Person
another community
on May 8, 2020 at 9:44 pm
Person, another community
on May 8, 2020 at 9:44 pm

@Chris

I completely agree with you. From what I heard officials in Santa Clara and nearby counties say, it isn't only about testing. There needs to be robust contact tracing set up as well.

Sarah Cody is working with officials from nearby counties, not independently. The public health officials working on this are experts. It's not just about looking at raw data. There is a lot more to it than that. I'm sure they have been working on different scenarios and strategies behind the scenes. If anything, I feel much safer here than anywhere else in the US. Our numbers are very low because of the shelter in place. I would rather keep it that way. We are slowly opening things up, but in a calculated way. I would rather have the public health experts have everything in place before we reopen rather than just winging it like other counties.

We have low levels of covid cases now. Do we remember what happened back in February? It started with just a couple of cases and the number grew very quickly. That could easily happen again in the blink of an eye...even with just one infected person. That's all it takes. Let's be grateful that so many lives have been saved and that they are getting everything set up for us to reopen SAFELY.


John
Professorville
on May 8, 2020 at 10:33 pm
John, Professorville
on May 8, 2020 at 10:33 pm

Person,

Thanks for making my point. We have incredibly low infection rates, possibly due to early SIP. No issues there. But SIP no longer makes sense given those numbers.

Why do you trust that officials are studying and making plans? How do you know they have strategies and scenarios in the works? They’ve said nothing about it other than “we’re the experts, do as we say”.

We deserve a real plan and real explanations for these choices. People would be more willing to comply if we had that honest dialogue.


John
Professorville
on May 8, 2020 at 10:35 pm
John, Professorville
on May 8, 2020 at 10:35 pm

Person,

Thanks for making my point. We have incredibly low infection rates, possibly due to early SIP. No issues there. But SIP no longer makes sense given those numbers. Logic tells us that when the risk diminishes, you ease the alert, not tighten it.

Why do you trust that officials are studying and making plans? How do you know they have strategies and scenarios in the works? They’ve said nothing about it other than “we’re the experts, do as we say”.

We deserve a real plan and real explanations for these choices. People would be more willing to comply if we had that honest dialogue.


chris
University South
on May 8, 2020 at 10:51 pm
chris, University South
on May 8, 2020 at 10:51 pm

John,

The restrictions are being relaxed. A number of modifications were effective last Monday. If cases continue down, more restrictions can be relaxed.

Do you not think that given the current level of cases, not just in SCC but the Bay Area and California, the number of cases would explode if all restrictions were relaxed. Which restrictions would you relax and which would you keep at this time?


m2grs
Midtown
on May 8, 2020 at 11:08 pm
m2grs, Midtown
on May 8, 2020 at 11:08 pm

I'd like to urge readers check out this wikipedia link: Web Link

When is the last time so many "famous" people in the world have died in such a short time due to one disease?

Yes most of are older people. But that's why testing is important. If there is a commitment to test in scale the cost will go down dramatically too.


musical
Palo Verde
on May 9, 2020 at 2:53 am
musical, Palo Verde
on May 9, 2020 at 2:53 am

^ Donald Kennedy is the only name I recognized in that wikipedia Covid list.


Person
another community
on May 9, 2020 at 6:23 am
Person, another community
on May 9, 2020 at 6:23 am

@ John

Restrictions are in fact being lifted due to the low infection rates (parks are now open, outdoor businesses and construction can operate, new outdoor activities are allowed, non-essential medical procedures and surgeries can resume). A SIP order doesn't mean you have to stay home either; there is still a lot you can do. You can technically still visit family and/or friends if you really wanted to; nobody is going to arrest you for doing that. The main things that are shut down right now are stores, restaurants (for dine in), highly trafficked public areas. Which of these would you open up? And how would you handle the sudden increase in cases, which will inevitably happen, especially with travel? As soon as the SIP lifted not only will we have people from Santa Clara county in local businesses but people from other counties, and other states, coming to visit friends and/or family, or coming to shop or dine. I think people are underestimating how quickly this virus will spread as soon as we start to open up.

You cannot use the logic of low infection rates means we get rid of SIP. That simply does not work. The low infection rate is a temporary result. When restrictions are lifted, infection rates increase. And if lifted too soon, they will spike. The only way to ensure that the number of infections stay relatively low is to ensure proper testing and contact tracing, which we do not yet have in place. And by easing restrictions slowly, the county can more closely follow new cases and ensure they have an understanding of how and where transmission is happening.

Would you prefer that we just lift SIP and go back to where we were in February?

Of course the officials are studying and making plans. Do you think they are just casually sitting around? These are people who are well educated and experienced. This is not just one person setting guidelines, but rather a collaborative effort among different bay area counties. You are forgetting that these are the same people that ultimately saved so many lives in the bay area and took this seriously from the beginning.

There is in fact dialogue from Santa Clara and nearby counties regarding SIP orders. They have been transparent in that this is a new virus and how they are working through this. I have read and listened to interviews not only with Dr. Sara Cody, but with other health officials, including several at UCSF. I for one am grateful that we are taking things slow here and saving lives in the process.

Web Link

Web Link

Web Link


John
Professorville
on May 9, 2020 at 7:34 am
John, Professorville
on May 9, 2020 at 7:34 am

Person,

“You cannot use the logic that low infection rates means we get rid of SIP”. Huh? What benchmark would you use then? Low infection rates (some of the lowest in urban America!) is *precisely* the benchmark to relax restrictions. That’s actual, not projected, evidence of what is happening right now in our area.

You also say that “infections would spike”. Really? How do you know? We have no idea how many active spreaders are out there right now, but data tells us there are far fewer than in February when we barely knew anything about the disease. And what constitutes a Spike anyway? 10 deaths? 100? Isn’t there some level of acceptable risk? I think the vast majority of citizens believe there has to be, but not Dr. Cody.

If you recall, SIP was implemented as a tactic. It was an extreme measure to flatten the curve and make sure hospitals weren’t overrun. The curve has flattened. The hospitals are empty. [Portion removed.]

I want to repeat that no one is advocating for a total opening up. Far from it. But there are many things we could do, and are doing, to open up with significantly reduced risk. Masks, curbside retail, antibody testing, and more. Yes, there would be risk of infection but people in our area are acting responsibly. And we would are more knowledgeable and better prepared, if a significant spike materializes.

[Portion removed.]


midtown2
Midtown
on May 9, 2020 at 7:51 am
midtown2, Midtown
on May 9, 2020 at 7:51 am

Why is receiving a negative diagnostic test reassuring? Some diseases take a long time to develop: a negative test in that case can be encouraging. But with this disease?
And what about a positive result if you were asymptomatic? You might conclude that you were one of the people who have it without ever having symptoms. Or that you were only in some early stage.


m2grs
Midtown
on May 9, 2020 at 12:09 pm
m2grs, Midtown
on May 9, 2020 at 12:09 pm

@midtown2, nothing is perfectly risk-free. But more testing definitely reduces the risk, and makes people more comfortable.

By the way, what is a Contact Tracer? Modern day KGB agent?

It seems to me China is winning. They have built the vast AI-powered monitoring system, with cameras not only on every corner of the streets, but on every bus, every taxi, every hallway in every building, plus the tracing of cell phones everywhere, and drones to fly over and warn people of violations.

It is dystopian. But violent crimes are rare because of this vast system. During COVID19 the system is being used to track potential contacts of infected persons very efficiently, much better than the utterly laughable low-tech so-called Contact Tracer agents.




Joe Rich
another community
on May 9, 2020 at 5:58 pm
Joe Rich, another community
on May 9, 2020 at 5:58 pm

Thank you. I am from Santa Clara, and I have been saying there is something wrong in Santa Clara and California for weeks, but everyone is so mesmerized by Newsom that they will not question his daily low info ramblings. This is the best article on the lack of testing in Santa Clara I have seen. Our testing rate is about half of the national average.


Jill
Mountain View
on May 9, 2020 at 6:41 pm
Jill, Mountain View
on May 9, 2020 at 6:41 pm

Why is Verily able to test anyone with no symptoms in Sacramento Web Link
, however in Santa Clara, even though this was one of the first places they had testing, they still don't offer testing without symptoms - how are we going to catch the asymptomatic super spreaders? In Australia, after finding that a nursing home worker with no symptoms (the 'tiniest tickle in their throat') was positive (in a nursing home where 17 patients have died so far) , they have advised all members of public can be tested regardless of whether have any symptoms. There is also pollen around and with the warmer weather some seasonal allergy symptoms have gotten worse - many people may be confusing allergy symptoms with their sore throat symptom (CDC updated symptoms of Covid 19 to include sore throat only in late April). I agree that of course frontline workers need to be tested first but shouldn't the tests have been ramped up by now that anyone could get one?


Charles
College Terrace
on May 9, 2020 at 7:06 pm
Charles, College Terrace
on May 9, 2020 at 7:06 pm

I’ve been trying to get tested for over a month. No luck.
It makes no sense that this country cannot implement sufficient testing. DT said anyone who wants a test can get one. I want a test and cannot get one.


resident
Downtown North
on May 9, 2020 at 7:31 pm
resident, Downtown North
on May 9, 2020 at 7:31 pm

Tonight's news says Anthony Fauci as well as the directors of the CDC and FDA were exposed to COVID-19 at the White House, presumably from Mike Pence's press secretary who has tested positive. Frequent testing of White House staff will hopefully limit the risk to senior citizens like Dr Fauci. Testing does work to reduce the spread of the virus, but only if it is widely available. CNN News report: Web Link


Person
another community
on May 9, 2020 at 8:32 pm
Person, another community
on May 9, 2020 at 8:32 pm

@John

Low infection rates doesn't mean you get rid of SIP. It is a good indicator that we have beaten the first hurdle of flattening the curve, and are currently in a good place. But what we need in order to lift the SIP is (as mentioned before): 1) Higher levels of testing, and 2) Robust contact tracing. You cannot reopen successfully without those things in place. We are still re-opening cautiously, but at a slower pace, while testing and contact tracing are ramped up.

You are very focused on the "now". Right "now" we have few infections. True. But that can and will change in an instant. We don't lock down our county borders. As soon as businesses open up and the SIP is lifted (and over time), people will be visiting from other cities, counties, states, and countries. We live in a diverse area with a lot of travel and different groups of people who could have visitors. Think about when universities re-open and students from all over the world come back here. And think about how quickly this virus could spread through dorm rooms, college campuses, schools, etc. once they re-open. That's just one example of why we can't focus on the cases as they stand now. We flattened the curve to not overwhelm hospitals, and get cases down to a manageable rate, so that....we can better manage them...and that takes testing and contact tracing.

Infections will increase when the SIP is lifted, from people infected in this area (in any of the nearby counties), or anywhere else. It really doesn't matter that you may think we have few cases now. They will increase when things open up. This is common knowledge, and also common sense. And they may spike, if we cannot identify positive cases and isolate them. This is precisely what happened in February. It started off with just a couple of known cases and they couldn't keep up with the spread after a point in time. This is a very infectious disease. If we go back to normal without protocols in place, there will inevitably be another spike.

Are you stating that you prefer to just open everything up and then shut down again later when there will be another spike in cases? What Sara Cody and others are trying to do is to not have that happen and instead re-open slowly but not have to go back to another SIP. They are monitoring case numbers as restrictions are lifted, and if things look good, they will continue to lift additional restrictions. Meanwhile, we are getting everything in place to manage the disease which will inevitably affect our county and others. And buying time for new treatments to become not only identified but available for use (Remdesivir is not currently widely available, so at this point there really are no treatments).



midtown2
Midtown
on May 10, 2020 at 9:38 am
midtown2, Midtown
on May 10, 2020 at 9:38 am

M2grs, thank you for your response to me. I wanted to answer right away but the available laptop didn't permit that.
Nobody has answered my question - why is a negative diagnostic test result reassuring?
I will answer myself: it is reassuring if you and 95% of the total number of residents in Palo Alto all have negative diagnostic tests.
Then the chance of being infected while going out in Palo Alto is low.
If you don't know that 95% have this negative result, then you cannot be sure that you won't be unlucky the next time you go out.
If 95% of Palo Altans test negative and none of them leave town and nobody from outside comes in, that's reassuring, and normal life resumes.


resident
Downtown North
on May 10, 2020 at 4:38 pm
resident, Downtown North
on May 10, 2020 at 4:38 pm

Mike Pence says if one of your employees tests positive, you don't have to self-quarantine. Just get get tested every day and have all your other employees get tested every day. There should be no problem getting tests for everyone.


Realist
Los Altos Hills
on May 11, 2020 at 12:27 pm
Realist, Los Altos Hills
on May 11, 2020 at 12:27 pm

@Person

You are putting up a strawman argument.

I read entire discussion on the board. No one is advocating complete opening up.

I have heard Dr. Cody speak.

I still can't find any outrage among SCC citizens regarding the following:

1. If it was known that 1000 contact tracers are needed then why are we still weeks away from meeting that goal. With nine weeks in this should have been accomplished within four weeks. I thought this was an emergency.

2. SCC had the highest infection rate in early March, after Seattle in the country if I recall. Why do we have less testing than Sacramento, LA or neighboring counties in the bay area. Why is it easier it get tested in Hayward or Fremont than in SCC.

3. Do you think Spain and other places that are slowly opening up have lower infection rate than SCC?

4. If you are concerned about the deaths due to Covid-19 we should consider the risks and deaths due to Covid-19 in long term due to negative health stress of all kind that people are going to suffer due to depression, loss of income, and other consequences of fighting the epidemic including extending SIP more than necessary.

5. I don't know if the public officials are making right decisions and planning. I hope they are. But I would like that to be independently verified. Any magic numbers need to be verified. We should always question "why" when any information is given.

6. Why is the bay area SIP getting longer than Wuhan and Italy.

7. A trade off is part of decision making. No one can predict the future. The dire picture you paint of what will happen if SIP is lifted today won't change irrespective of when it is lifted between now and August.

8. There going to be no better treatments available for at least next 3 months.

9. We are not New Zealand or Taiwan. We have to plan assuming that infections would never be non-zero till vaccine is available. You can't prevent people from other parts of the country visiting SCC. We need to pick a number that we are willing to accept as daily or weekly infection cases.

10. Opening up and ending SIP is not a binary. It is gradual, careful and commonsense. Why is picnic ban in large public park if you are alone or with your family group. Makes no sense. It is easy to enforce how many number of people you are going to allow in a park or on a beach. Social distancing is easy to maintain if you open up public places for activities. The same with retail. Why not allow non-essential to start opening up by offering curbside pickup. You can also allow retail to re-open by restricting number of people that can be indoors.

11. Who is going to bear the economic costs of people who run out of money. Do you want to increase homeless rate in effort to chase a perfect criteria to reopen.


Politicians are not the best people who understand risk management in emergency situations like we are facing. Dr. Cody and county were one week too late in imposing the SIP. Now they are one month too late in gradually bringing SIP to an end.


Realist
Los Altos Hills
on May 11, 2020 at 12:33 pm
Realist, Los Altos Hills
on May 11, 2020 at 12:33 pm

@Person

You are putting up a strawman argument.

I read entire discussion on the board. No one is advocating complete opening up.

I have heard Dr. Cody speak.

I still can't find any outrage among SCC citizens regarding the following:

1. If it was known that 1000 contact tracers are needed then why are we still weeks away from meeting that goal. With nine weeks in this should have been accomplished within four weeks. I thought this was an emergency.

2. SCC had the highest infection rate in early March, after Seattle in the country if I recall. Why do we have less testing than Sacramento, LA or neighboring counties in the bay area. Why is it easier it get tested in Hayward or Fremont than in SCC.

3. Do you think Spain and other places that are slowly opening up have lower infection rate than SCC?

4. If you are concerned about the deaths due to Covid-19 we should consider the risks and deaths due to Covid-19 in long term due to negative health stress of all kind that people are going to suffer due to depression, loss of income, and other consequences of fighting the epidemic including extending SIP more than necessary.

5. I don't know if the public officials are making right decisions and planning. I hope they are. But I would like that to be independently verified. Any magic numbers need to be verified. We should always question "why" when any information is given.

6. Why is the bay area SIP getting longer than Wuhan and Italy.

7. A trade off is part of decision making. No one can predict the future. The dire picture you paint of what will happen if SIP is lifted today won't change irrespective of when it is lifted between now and August.

Continued..


Realist
Los Altos Hills
on May 11, 2020 at 12:35 pm
Realist, Los Altos Hills
on May 11, 2020 at 12:35 pm

Continued from prev


8. There going to be no better treatments available for at least next 3 months.

9. We are not New Zealand or Taiwan. We have to plan assuming that infections would never be non-zero till vaccine is available. You can't prevent people from other parts of the country visiting SCC. We need to pick a number that we are willing to accept as daily or weekly infection cases.

10. Opening up and ending SIP is not a binary. It is gradual, careful and commonsense. Why is picnic ban in large public park if you are alone or with your family group. Makes no sense. It is easy to enforce how many number of people you are going to allow in a park or on a beach. Social distancing is easy to maintain if you open up public places for activities. The same with retail. Why not allow non-essential to start opening up by offering curbside pickup. You can also allow retail to re-open by restricting number of people that can be indoors.

11. Who is going to bear the economic costs of people who run out of money. Do you want to increase homeless rate in effort to chase a perfect criteria to reopen.


Politicians are not the best people who understand risk management in emergency situations like we are facing. Dr. Cody and county were one week too late in imposing the SIP. Now they are one month too late in gradually bringing SIP to an end.


Messifan
Ventura
on May 11, 2020 at 2:50 pm
Messifan, Ventura
on May 11, 2020 at 2:50 pm

We may never open up unless we encourage local politicians to push back on Sara Cody. She still does not understand the governors order. Web Link


John
Professorville
on May 11, 2020 at 8:12 pm
John , Professorville
on May 11, 2020 at 8:12 pm

Dr. Cody continues to stonewall, dither, and deny. Now she claims she hasn't had the chance to "better understand" the Governor's Stage 2 order. Huh?

How is it that Mayors and health officials across California have somehow managed to review the order and find ways to comply, just a little bit? This includes LA County which has 5x the infection and death rates as the Bay Area.

How is it that Cody claims we don't have enough PPE and tests and contact tracers -- when she has had 10 WEEKS to plan and acquire them?

People, think about the perverse logic here. It was her responsibility to devise a plan and gear up. Instead of doing that, she chose to do lots of press conferences, Podcasts, newspaper interviews, etc. -- basically any place to trumpet her brilliant plan to flatten the curve. Now, rather than accept responsibility and evolve with new circumstances, she feigns ignorance and actually twists her own failure to act into the very reason to maintain the complete SIP order.

This is what happens when our elected leaders abdicate decision-making to narrow-minded, unelected bureaucrats who are more interested in looking smart at medical conferences than actually solving the crisis.


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