Ahead of the Curve

This morning, I sat down to try to get a handle on the state of the epidemic. As I started to write, a friend texted me to let me know that a case of Covid-19 had just been reported at the nursing home that is literally down the hill from me. This is critically important for everyone in Issaquah, the town where I live, to know. This brought a new immediacy to my search for information. The results were unsettling to say the least.

I started at the top. The CDC website, the official voice of the federal government on the outbreak. They identify 164 cases with 11 deaths across 19 states. According to the New York Times, there are 307 cases of coronavirus and 17 deaths as of Friday. How is this disconnect possible? How is it the voice of the agency in the federal government tasked with controlling outbreaks can’t do for us what the NYT and many other agencies doing. 

The CDC website is riddled with caveats.

They won’t tell us how many cases are being investigated.
“CDC is no longer reporting the number of persons under investigation (PUIs) that have been tested, as well as PUIs that have tested negative. Now that states are testing and reporting their own results, CDC’s numbers are not representative of all testing being done nationwide.”

They won’t tell us how many cases have been tested.
“ As of March 5, 2020 1,583 patients had been tested at CDC. This does not include testing being done at state and local public health laboratories, which began this week.”

And the most staggering to me:
“This page will be updated regularly at noon Mondays through Fridays. Numbers close out at 4 p.m. the day before reporting.”
As if outbreak is taking the weekend off.

Even the numbers from yesterday are an underestimate. Trump, himself, mentioned a count of 240 in his press conference yesterday AT CDC. Was it too much work to share that with the website manager? In that same press conference, Trump announced that he wanted the cruise ship passengers in San Francisco to stay on the ship. “I would rather because I like the numbers being where they are,” Trump continued. “I don’t need to have the numbers double because of one ship that wasn’t our fault.” Kind of gives us a hint as to what’s happening. (As a side note, it’s interesting that he thinks 240+24=2×240. Math is not a strong suit.)

In other words, CDC must have more up to date numbers, but they are not sharing them publicly. This is an outrage with deadly consequences. Ignorance is the absolute enemy in this and misinformation breeds panic and feeds poor decision making.

The problem here is that all the public health departments in the country have historically taken their cues from the CDC. The Washington State Health Department, website reports 11 deaths, and 79 cases. At the same time, news outlets are widely reporting 14 deaths. As far as the number of cases, the state website says, “Please contact the local health department for information”.

So, I check the public health website for King County, home to Seattle and Issaquah. They note that, “Eleven (11) people in King County have died. It’s important that everyone take steps to reduce the spread of novel coronavirus. This is a quickly evolving situation and this site will be updated frequently.” Nothing about the number of tests or number of cases. Then comes the kicker. “Additional updates are available from the federal CDC and Washington Dept. of Health.” The buck passing circle is complete.

Finally, I check Snohomish County, the site of the nursing home where this outbreak exploded. This is the only website I found with complete information. They list the number of deaths and not just the number of cases, but the age and health status of every case. Who is in the hospital, who is at home, and who has underlying conditions. They have not updated since yesterday morning, but I will give them a pass on this. This is a far smaller Department and they are literally at the center of this. They are in the trenches, overwhelmed with a true disaster.

So, I do not expect to hear about the new case down the hill from me from any officially source until sometime on Monday. That is not how to disperse essential news. It is how to spread disease.

We are confronting an epidemic of misinformation. And there is no question who is the index case. Everyone in public health understands that keeping passengers on the Diamond Princess in Japan during the first cruise ship outbreak was a huge mistake with disastrous consequences, both for those on the ship and for the people infected by those leaving the ship. Pence is undoubtedly being advised to get passengers off the ship. But Trump in his consummate ignorance and his obsession with spin, would do it all over again, just to look better in tomorrow’s news cycle.

Viruses don’t listen to spin. Viruses don’t watch Fox News. Viruses laugh at alternative facts. Viruses don’t care whose “fault” any of the cases are. They don’t even care what country they are from. We desperately need openness, honesty, transparency, and truth. We have an administration capable of none of these things.

People are dying as a result.