Thursday, December 17, 2020

CoViD-19: We're Doing This All Wrong | Some San Diego Restaurants Defy State Orders Under Judicial Cover

Ficus Before the DDD (Taken 12.6.2020)

It's after 10pm and I really need a speakeasy night, so I'm gonna save some of today's reading and links and emails for tomorrow. Tonight we're celebrating because Ficus is feeling much better and gave us a 'yule log' and compared to the past three days, that was certainly an assuring sign. And not to be mean, but the new tenants didn't show up today, so I don't know what's going on there, but for now the space is still just ours and I'm pretty stoked about that. We went on a dog walk just after the rain for the first time in days and now mama needs some whiskey. 

I spent a lot of time railing against the strip-club ruling, so my rant and today's data is all after the jump. I'll catch up with you tomorrow. 

UPDATE 12/18/2020: 

I have so much to say about the Strip Club Ruling that has given the go-ahead for strip clubs and restaurants to be open, in direct opposition to the State's Stay-At-Home order. This is already being appealed by the State and County. 

Let's remember that this lawsuit was originally filed in October (LA Times) when San Diego County new daily cases were anywhere from a low of 143 (Oct 14) to  high of 430 (Oct 22) and our rolling percent positive was 2.7% (Oct 27). We were still in the red tier with a 7.4 unadjusted case rate and 6.5 adjusted case rate with a 3.5% 7-day positivity rate (as reported October 27, 2020.). We were seeing an uptick in community outbreaks, but case investigation and contact tracing were still in the high 90s. 

By November 6th, when the judge granted the request for the temporary injunction, the daily cases were in the high 200s to high 400s, with a Nov. 3 14-day rolling average of 3.0%, a 7.4 adjusted case rate per 100k and 8.7 unadjusted. We were by then in the purple tier danger zone, waiting for our second consecutive week to come.

It is now December 17, and yesterday's ruling came at a time when we have a 29.5 cases per 100,000 adjusted and a staggering 52.7 unadjusted cases per 100,000 with a 10.9% 7-day average positivity rate (as of state assessment on Dec 15.) Remember that under 7 per 100k would get us back to the red tier. This isn't an arbitrary number made by the County or the State, these are CDC incidence thresholds which you can see in this chart (note that the chart looks at weekly cases per 100k, so 49 or under would allow restaurants to reopen outside.) Using San Diego's current adjusted rate of 29.5, we're at 206.5 cases per 100,000 people per week; unadjusted is 368.9 per 100,000. Every day we're setting records on cases and deaths in the county, in the region, in the state, and across the country.

I've been keeping track of the community outbreaks. Since we went into purple tier, there have been 300 community outbreaks. As of Wednesday, Dr. Wooten said that we had 219 community outbreaks that were still considered active. 

November 15-December 16:
Business 95
Restaurant/bar 33
Retail 34
Restaurant    14
Grocery 9
Faith-based Setting 24
Government 11
Daycare/preschool 23
Healthcare 11
Construction 4
Emergency Services 5
Food/Bev Processing 6
Higher Ed 2
tk-12 school 9
Warehouse/Distribution 9
Adult Daycare 1
Gym 3
Hair Salon/Barber 1
Hotel/Resort/Spa 3
Private Residences 2
Other 1

Bear in mind that almost 53%-55% of new cases, when asked, say there was no potential community exposure setting. (COVID-19 Watch) It also doesn't tell us where "cases" are happening, only outbreaks, defined as 3 or more cases from people of different households at the same location within 14 days. When judges are asking for "specific evidence" that one setting or another is the source of spread, they know that is an impossible ask with an invisible virus spread through aerosols that can have up to a 14-day incubation (CDC)

You can present case studies from the past nine months from JAMA and NEJM and Johns Hopkins and the WHO and CDC and scientists all over the world. Finding exact localized data is even more impossible when you're keeping outbreak data confidential, symptom incubation can be up to fourteen days, contact tracing is reliant on the community participating honestly and openly, and people are scared or shamed to out their businesses, workplaces, restaurants, churches, parties, and gatherings. 

But this activist judge, and others like him, and all the open-the-economy people are never changing their minds. They'll talk about the survival rate (without mentioning long-haulers or irreparable damage or even medical bills), they'll talk about underlying conditions and how 'those people' should be the ones who stay home, only slightly attempting to hide the racism (eugenics) because the majority of people dying are BIPOC, and they'll talk about herd immunity...and why wouldn't they when the leadership at the top has been preaching all of this bullshit all along? (We want them infected’: Trump appointee demanded ‘herd immunity’ strategy, emails reveal. Then-HHS science adviser Paul Alexander called for millions of Americans to be infected as means of fighting Covid-19. - Politico 12.16.2020

The State has already appealed the decision. The County Board of Supervisors is having an emergency closed session board meeting on Friday at 1:30pm but had already voted 3-2 that in the event that the judge upheld his previous ruling, the county would appeal. This is going to be a long and ugly fight that could potentially go to higher courts and we kinda know how that's gonna go after all the court-packing that's happened the past four years. 

In the meantime, restaurants are already reopening, thinking that wiping down chairs and tables is "taking all precautions" while they cram tables into parklets with plastic roofs and walls. 
People are going to continue to get sick. 
People are going to need medical care they can't afford. 
People are going to need hospitalization. 
Locally our cases have resulted in a 4-6% hospitalization rate.  Statewide that number is 12%. 20% of those have needed ICU care, and we're already more or less out of staffed ICU beds. With ten days with over 2,000 new cases this month alone, it is going to be grim. 

On Wednesday, the county reported 24 staffed ICU beds, which may have gone up because we are getting waivers for nurse to patient ratios and 88 people have already died this week alone. 

But go ahead, eat at a restaurant. Go drink beers with non-household friends. You do you. Risk yourself. Risk the staffs who spend hours on end in tiny kitchens. Risk the entire service sector, because who gives a shit about them anyway? Risk all of us who have to walk in your vape trail or stand next to you in line while getting household essentials. Anyway, a vaccine is coming and this is nothing more than the flu, right? 

This is a goddamn outrage. 

  • COVID-19:
  • Politics/News/Other Reading:
  • Global COVID-19 Stats (JHU 12/17 9:28pm):
    • 74,952,221 Known Cases
    • 1,662,127 Known Deaths
  • US COVID-19 Stats (COVID Tracking Project):
    • 241,620 New Cases/17,004,147 Known Cases (9.7%+ Change over 7 Days)
    • 3,438 New Deaths/302,261 Known Deaths
    • 114,237 Current Hospitalizations
    • 21,900 Currently in ICU
    • 7,847 Currently on ventilator
  • California COVID-19 Stats:
    • 52,281 New Cases/1,723,362 Total Cases (3.1% increase)
    • 379 New Deaths/21,860 Total Deaths (1.8% increase)
    • 11.5% 14-day test positivity rate
    • 16,426 Hospitalizations (+540 patients, +3.3% from prior day) 
    • 3,392 ICU hospitalized in CA (+95 patients, +2.8% from prior day)
    • 1,260 ICU beds available (-71 from prior day)
  • San Diego County Stats
    • State Data:
      • Southern California ICU Bed Availability: 0.0%
      • 2,807 New Cases/114,248 Total Cases
      • 23 Deaths/1,217 Total Deaths
      • 52.7 cases/100k population (Based on week ending 12/8, Assessed on 12/15. Unadjusted Case Rate)
      • 10.9% Test Positivity (Assessed on 12/15)
      • 13.5% Health Equity Positivity (Assessed on 12/15)
      • 1,186 hospitalized patients (+13 patients, +1.1% from prior day)
      • 301 ICU hospitalized patients (-6 patients, -2% from prior day)
      • 168 ICU beds available (-7 from prior day)
    • County Data:
      • San Diego County COVID-19 Update – 12-17-2020 - County News Center
      • San Diego is hitting 8 triggers: High adjusted case rate (29.5), high community outbreaks (38), COVID-19 syndromic increasing (6%), influenza like illness increasing (4%), increasing day over day hospitalizations (12.1%), low ICU Capacity 16%, high testing positivity 9.5%, low case investigation 42%
      • 2,604 New Cases/116,852 Total Cases 
      • 22 New Daily Deaths/1,239 Total Deaths
      • 9% Daily Test Positivity/9.9% (7-day avg after 7-day lag)/8.7% Test Positivity (14-day average)
      • 29.5 cases/100k population (Assessed on 12/15. Unadjusted case rate per 100,000 excluding prisons.) 
      • Case Investigation is 42% (under 70% goal)
      • 12.1% Increasing Day Over Day Hospitalizations (over 10% trigger. 215% increase over 30 days. 1,134 COVID Confirmed Patients)
      • 16% ICU Capacity (under 20% Trigger. 144% increase over 30 days. 288 COVID confirmed patients)
      • 8 New/38  Community Outbreaks (7-day)
        • Business 15
        • Restaurant/bar 2
        • Grocery 1
        • Faith-based Setting 4
        • Daycare/preschool 7
        • Healthcare 2
        • Construction 1
        • Food/Bev Processing 1
        • tk-12 school 2
        • Warehouse/Distribution 3
  • Universities:

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