covid19policy

Brittney Palmer BPalmer@atlantaregional.org
to:
cc: Stephen Causby SCausby@atlantaregional.org


Dear Chairman Nash,
I’m a resident of Gwinnett County and wanted to thank you for the taking the lead in declaring a state of emergency in our county.

I wanted to push for even more stringent measures, as soon as possible. I did a rough analysis, and based on the current healthcare capacity of Gwinnett County, we would need to slow the spread of COVID19 over 1.9 to 5.7 years to not overwhelm our system.

For a quick comparison, I graphed the number of hospital beds (1,727 total available, and assuming 70% are in use already only 518 available), against expected hospitalizations.

image.png

The analysis to go from there, to number of months to “flatten”, is as follows.

image.png

This is important because overwhelming our healthcare system could (by some estimates) increase the mortality rate 10-fold.

Additionally, I spoked yesterday with Quinton Zondervan, city councillor in Cambridge, MA (where I go to school normally), who wrote to his city council

We need to shut down the city! Italy has 60 million people, we have 7 million people in Massachusetts. 2 weeks ago, Italy had about 1,600 confirmed cases, we have 164 in Massachusetts right now as of yesterday. Yesterday, Italy surpassed 24,000 cases and had 368 deaths, just yesterday alone! Again, 368 people died in Italy from coronavirus yesterday! We need to shut everything down now to prevent our healthcare systems from getting overwhelmed.

By comparison, Georgia has 9 million people, and 146 cases as of yesterday. We will become like Italy without severe intervention, where overwhelmed doctors and nurses have to choose who to save.

Yesterday Councillor Quinton and others petitioned the Massachusetts governor for a shelter-inp place, the text here.

From the above rough analyses, I would like to advocate for three things:

Immediate shutdown, urgently, to get us closer to 20% infections than 60%. Push for this at all levels of government. Hopefully this contains the spread to "hotspots" allowing neighboring less-affected regions to share resources
Increased capacity: Look for any way to increase hospital capacity, including building makeshift hospitals. We need some way to increase production of masks, ventilators, and beds, as well as staffing. Perhaps we could even solicit donations from philanthropists in other countries
In the medium-term, plan for lots of testing and contact tracing: We can't actually stay shutdown forever. South Korea, China, and other nearby countries have both pursued aggressive tactics here, that seem to have worked. China reported 1 new (domestic) case yesterday, so there's hope.

My mother is over 60 and has health complications, and I can’t rest easy until my mother no longer feels like she needs to go into the office to work. That’s why I wanted to reach out locally.

Thank you very much for your decade+ of service to Gwinnett County. Please let me know if there’s anything I could help with.

With warm but urgent wishes,
–Nancy Ouyang

My sources are as below:

Gwinnett Hospital Beds: (Eastside Medical Center, Northeast Georgia Medical Center Braselton and Gainesville, Northside Hospital Duluth and Gwinnett): American Hospital Director.
    I made the 70% current utilization based on reports that at Boston the hospitals are close to 93% in use normally, but have cancelled surgeries to get closer to 70%

20 to 60% of population infected, Prof. Mark Lipsitch, Professor of Epidemiology at Harvard
Gwinnett County population, 2018 US Census 
19%, or approx. 1 out 5 infections will require hospitalization.Journal Am. Medical Association
Median hospital stay is 10 days. Journal Am. Medical Association 

Dear Chairman Nash,
I’m a resident of Gwinnett County and wanted to thank you for the taking the lead in declaring a state of emergency in our county.

I wanted to push for even more stringent measures, as soon as possible. I did a rough analysis, and based on the current healthcare capacity of Gwinnett County, we would need to slow the spread of COVID19 over 1.9 to 5.7 years to not overwhelm our system.

For a quick comparison, I graphed the number of hospital beds (1,727 total available, and assuming 70% are in use already only 518 available), against expected hospitalizations.

image.png

The analysis to go from there, to number of months to “flatten”, is as follows.

image.png

This is important because overwhelming our healthcare system could (by some estimates) increase the mortality rate 10-fold.

Additionally, I spoked yesterday with Quinton Zondervan, city councillor in Cambridge, MA (where I go to school normally), who wrote to his city council

We need to shut down the city! Italy has 60 million people, we have 7 million people in Massachusetts. 2 weeks ago, Italy had about 1,600 confirmed cases, we have 164 in Massachusetts right now as of yesterday. Yesterday, Italy surpassed 24,000 cases and had 368 deaths, just yesterday alone! Again, 368 people died in Italy from coronavirus yesterday! We need to shut everything down now to prevent our healthcare systems from getting overwhelmed.

By comparison, Georgia has 9 million people, and 146 cases as of yesterday. We will become like Italy without severe intervention, where overwhelmed doctors and nurses have to choose who to save.

Yesterday Councillor Quinton and others petitioned the Massachusetts governor for a shelter-inp place, the text here.

From the above rough analyses, I would like to advocate for three things:

Immediate shutdown, urgently, to get us closer to 20% infections than 60%. Push for this at all levels of government. Hopefully this contains the spread to "hotspots" allowing neighboring less-affected regions to share resources
Increased capacity: Look for any way to increase hospital capacity, including building makeshift hospitals. We need some way to increase production of masks, ventilators, and beds, as well as staffing. Perhaps we could even solicit donations from philanthropists in other countries
In the medium-term, plan for lots of testing and contact tracing: We can't actually stay shutdown forever. South Korea, China, and other nearby countries have both pursued aggressive tactics here, that seem to have worked. China reported 1 new (domestic) case yesterday, so there's hope.

My mother is over 60 and has health complications, and I can’t rest easy until my mother no longer feels like she needs to go into the office to work. That’s why I wanted to reach out locally.

Thank you very much for your decade+ of service to Gwinnett County. Please let me know if there’s anything I could help with.

With warm but urgent wishes,
–Nancy Ouyang

My sources are as below:

Gwinnett Hospital Beds: (Eastside Medical Center, Northeast Georgia Medical Center Braselton and Gainesville, Northside Hospital Duluth and Gwinnett): American Hospital Director.
    I made the 70% current utilization based on reports that at Boston the hospitals are close to 93% in use normally, but have cancelled surgeries to get closer to 70%

20 to 60% of population infected, Prof. Mark Lipsitch, Professor of Epidemiology at Harvard
Gwinnett County population, 2018 US Census 
19%, or approx. 1 out 5 infections will require hospitalization.Journal Am. Medical Association
Median hospital stay is 10 days. Journal Am. Medical Association 

Call notes:

Policy Goals:
Immediate Shutdowns:

  • A shutdown is urgently needed, combined with development of responses that can prevent transmission once things start to get up and running again.

Increased Resource Production:

  • To ‘flatten the curve’ below current hospital bed capacity would take years for some locations, so we need to combine shutdowns and other policies with increased production of masks, ventilators, and beds.

Resource Sharing:

  • Shutdowns help with shared distribution of resources between less and more impacted areas. Distribution of resources is currently a major problem.
  • Once hard hit areas are shut down enough to prevent the infection from spreading, plans should be made for sharing medical personnel and resources and between less and more impacted areas.

Testing and Contact Tracing:

  • We need to build up capacity for testing and contact tracing so places can get up and running after shutdowns finish.

https://www.ajc.com/news/local/gwinnett-declares-coronavirus-emergency/2ehc13nqjlHwP7JkJiw5FJ/
https://www.ajc.com/news/local/gwinnett-commission-chairman-signs-emergency-declaration-for-county/GMPdmup4qeJXpaoEQiFYrL/

Charlotte Nash, the chairman of the board of commissioners, signed the declaration to activate emergency powers in the county. Nash told Channel 2 Action News,
“We see this as likely to be a long-term situation,” she said. “Our community is pulling together.”

Q - Picture could be helpful for this. Q: Look at the South Korea wikipedia page, they have some very good graphs. Even a simple bar graph would be helpful. In addition to, not instead of. Tabular data for people who can process that, graphics will help.

QZ (from March 16 city council remarks): We need to shut down the city! Italy has 60 million people, we have 7 million people in Massachusetts. 2 weeks ago, Italy had about 1,600 confirmed cases, we have 164 in Massachusetts right now as of yesterday. Yesterday, Italy surpassed 24,000 cases and had 368 deaths, just yesterday alone! Again, 368 people died in Italy from coronavirus yesterday! We need to shut everything down now to prevent our healthcare systems from getting overwhelmed. SOUTH KOREA good news, need to learn from this:

confirmed: https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_Italy
good news: https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_South_Korea

The low death rate in South Korea
Bloomberg L.P. analyzed the reason for the low death rate in South Korea. South Korea experienced serious difficulties during the outbreak of MERS in 2015 due to a lack of test kits. Afterwards, the country approved rapid deployment of COVID-19 test kits, and now they are able to test more than 10,000 people a day. In neighboring Japan, only about 2,700 people in total have been tested for COVID-19 as of March 3. Officials in Seoul operate “drive-thru” testing stations for quick testing. Diagnostics company Seegene Inc. is also exporting its test kits to other countries including China, Europe and the USA