COVID-19 Modeling Displays Importance of Social Distancing

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COVID-19 Modeling Displays Importance of Social Distancing
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Van Do-Reynoso presenting to the Board of Supervisors

By edhat staff

Santa Barbara Public Health Department (PHD) shared data and models of the coronavirus (COVID-19) pandemic, expressing the extreme importance of social distancing cooperation.

PHD Director Van Do-Reynoso presented an update on COVID-19 during Tuesday morning's Board of Supervisors meeting which spurred a discussion of the social distancing timeline as models predict through November 2020.

Before launching into the results of the current modeling, Do-Reynoso explained these numbers are based on real-time data and are not set in stone.  "What I'm showing today is different than last week and will look different next week," she said. The long term projections are in a fluid state and may not provide precise data due to the uncertainty of the COVID-19 infection transmission rates and how to appropriately gauge social distancing measures.

Approximately 15% of the county's population is age 65 or older, making them more likely to develop serious COVID-19 related health impacts. However, Santa Barbara County has a lower population density compared to Los Angeles or San Francisco, which proves to be an asset, reported Do-Reynoso.

PENN MODEL

The Penn Model is recommended by the California Department of Public Health and is used as a rough estimate of what to anticipate. For reference, the University of Washington Model does not allow for variables to be estimated by population or density, so it can only predict on a statewide and national level.

The biggest predictor is of how Santa Barbara County will fare is social distancing, the percentage in social contacts going forward. 

The Penn model uses the social distancing percentage and compares it with the number of available hospital beds. For example, if 40% of the population complies with the order, COVID-19 hospitalizations within the county are expected to peak on June 25 with nearly 1,200 hospitalizations. That's beyond the capabilities of currently available beds. With 45% social distancing compliance, the peak is expected on July 16 with 682 hospitalizations. With 50% compliance, it peaks on August 20 with 274 hospitalizations, and with 55% compliance, the curve is almost completely flat peaking on August 31 with 42 hospitalizations.

Do-Reynoso explained how this modeling helps for surge planning within hospitals, alternate care sites, and equipment acquisition.

The current surge capacity with the five hospitals within Santa Barbara County (Santa Barbara Cottage, Goleta Cottage, Santa Ynez Cottage, Lompoc Hospital, Marian Regional Medical) allows for 569 medical/surgical beds and 131 ICU beds, a total of 699 beds for COVID-19 patients.

Comparing the number of beds to the Penn Model graph, it shows we'll need at least 50% social distancing compliance to not overwhelm hospital capacity. At 40% compliance, it exceeds capacity, at 45% the gap is reduced, and at 50% its well within the current capacity of beds, however, access to ventilators is lacking. 

The key takeaway is how important social distancing is to flatten the bell curve so as not to overwhelm healthcare facilities. Do-Reynoso explained there is no exact way to measure how well the community is adhering to social distancing rules, but PHD uses analytics from Google and Unacast. Based on that data, Santa Barbara County is anywhere between 40-60% compliant. 

"That's the lack of preciseness in modeling, we don't have a hardcore gauge," said Do-Reynoso.

Alternate Care Sites & Medical Equipment

As of Monday, hospital beds throughout the county are at approximately 40% capacity with 50 unused ventilators. Of the total available hospital beds, 376 medical/surgical beds are available while 91 intensive care unit (ICU) beds are available.

PHD is looking to immediately secure 20 hotel rooms for COVID-19 discharged patients who cannot quarantine in their homes. By mid-April they hope to secure and additional 80 hotel rooms. 

There is currently enough materials for 300 additional beds at an alternate care site, as well as the capacity for 100 more. These sites have yet to be finalized but PHD is recruiting staff. If local hospitals reach a collective 50% surge capacity, approximately 350 COVID-19 beds occupied, the alternate care site will be activated.

There are currently 97 total ventilators with 100 more requested as well as 500 disposables. Additional ventilators and PPE are attempting to be purchased by the hospitals.

Social Distancing Timeline

Based on the model's current predictions, social distancing may continue through October. Do-Reynoso re-stated that these models are not exact and they change very rapidly. However, she started seeing indicators in models that show if a community is doing well and lets up on social distancing, the curve does not complete the bell shape going downwards and can actually increase.

Supervisor Peter Adam expressed his concern about the economy if social distancing were to extend until November. 

"If we go on until November, there's people that will be injured that don't get sick and I don't think were balancing the needs of those people trying to make a living out there very well. We're overfocused, maybe rightly so... but I just know there's a tremendous amount of pain being loaded into this system at this time that's largely undetectable because everyone is in their homes," said Adam.

Adam went on to express his concerns about the economy and suggested finding the people with the greatest risk and isolating them, likening the situation to throwing out the baby with the bathwater. 

"We should start those discussions sooner rather than later until we run into failure, or rebellion, or whatever, ya know... at some point, people are going to stop cooperating and I don't think it's gonna last until November and then if we get to the point where we have to start arresting people... that's not America," said Adam.

Do-Reynoso stated she's unsure if maintaining social distancing orders until November is feasible. "I think it's a conversation that needs to happen in a variety of contexts and a variety of settings so that we as a community can land on a solution that is doable and protects vulnerable members of the community as well as safeguarding healthcare system," she said.

Supervisor Gregg Hart chimed in at the end of the discussion stating these are projections that help with future planning and show the biggest takeaway is social distancing is really important and it works.

Do-Reynoso agreed and stated these models are helpful tools and the next 8-10 days will determine what PHD will need to do differently in terms of modeling and planning. 


Additional updates on COVID-19 and related items were presented at Tuesday's meeting and a subsequent press conference held by District Attorney Joyce Dudley. The summaries of the updates are provided below:

HOMELESS POPULATION

A representative from the Santa Barbara County Office of Emergency Management stated during they Board of Supervisors meeting they are still working to secure sites in the south county area to serve the homeless population.

Last month a shelter was created in Santa Maria that generally houses 50 to 60 people but has hosted a maximum of 71 people. The county is supporting the shelter with food, security, laundry, and cleaning services.

A location in South County has yet to be determined as partnerships and staffing have not panned out as expected. Law enforcement is reporting an increase in close encampments and the county is working to separate those camps and provide housing and essential services. 

PRICE GOUGING

In a separate press conference on Tuesday, District Attorney Joyce Dudley announced they have received 11 reports of price gouging within the county. The DA's office has one full-time lawyer and one investigator assigned to these reports. In most cases, Dudley stated the increase was due to distributor costs passed on to the business owner, therefore not making it illegal. 

In terms of businesses not complying with the closure orders, Dudley states her office hasn't seen much of that as it appears most people are following the rules.

COUNTY JAIL

In a separate press conference on Tuesday, Sheriff Bill Brown reported the number of inmates at the County Jail continues to be much lower than previous years. There are currently 693 inmates whereas, on April 20, 2019, there were 933 inmates. There's also been a significant decrease in the number of arrests brought to the jail. From March 2019 to April 2019 there were 645 arrests, this year there were 300 arrests. 

Sheriff Brown also shared a positive story of local inmates helping healthcare facilities. In the jail's treatment program, a group of inmate volunteers has been making face shields for first responders and healthcare workers. They have currently assembled 800 face shields with the goal of making 2,400 shields in total. 

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therealbebe Apr 08, 2020 09:21 PM
COVID-19 Modeling Displays Importance of Social Distancing

What's needed is antibody testing, on everyone. There is a lab in Monterey that offers it for $68. It's a finger stick test, with results available in 10-15 minutes. Why on earth is this not the A#1 priority, if our government says they would like us to get back to normal as soon as possible? Things that make you go, "hmmm."

ChemicalSuperFreak Apr 08, 2020 09:53 PM
COVID-19 Modeling Displays Importance of Social Distancing

The particular test is not reliable, and is one of about a half dozen other copycat, worthless antibody assays. One such company was honest enough to provide some limitations to the testings, as follows: 1. This test has not been reviewed by the FDA. Based on the FDA Policy for Diagnostic Tests for Coronavirus Disease published on March 16th, 2020 during the Public Health Emergency, FDA allows the distribution of COVID-19 IgM/IgG Rapid Tests in the US during the EUA application and review. 2. Results from IgM/IgG antibody testing should not be used as the sole basis to diagnose or exclude SARS-CoV-2 (COVID-19) infection or to inform infection status. 3. Negative results do not rule out SARS-CoV-2 infection, particularly in those who have been in contact with the virus. Follow-up testing with a molecular diagnostic should be considered to rule out infection in these individuals. 4. Positive results may be due to past or present infection with non-SARS-CoV-2 coronavirus strains, such as coronavirus HKU1, NL63, OC43, or 229E. Follow-up testing with a molecular diagnostic should be considered to confirm the test results.

Zenyatta19 Apr 08, 2020 08:41 PM
COVID-19 Modeling Displays Importance of Social Distancing

I rarely if ever agree with Adam, but I have a great deal of respect for a man who does what he says he is going to do and is honest about it. What you see is what you get. He doesn’t talk out of both sides of his mouth. I would take Peter Adam over Das Williams any day of the week.

bosco Apr 08, 2020 01:47 PM
COVID-19 Modeling Displays Importance of Social Distancing

The real question I have is how much is social distancing working in relation to density? I understand this new model takes this into consideration , but I have trouble believing it. There are just far too many variables for any of these models to be accurate. Without comprehensive testing of asymptomatic people we have no way to know the true extent other than measuring lagging indicators like deaths and hospitalizations. Peter Adams has a point. We need to start taking the economy into consideration with these decisions. We need to start thinking about "smart" social distancing and not just a broad brush approach. Mandatory community testing, quarantine positive people, and isolate the vulnerable population. So far all I see in these models is wild speculation based on very little data. We need more data. We need MORE TESTING!!

Seabird Apr 08, 2020 03:46 PM
COVID-19 Modeling Displays Importance of Social Distancing

@ Bosco, STRONGLY AGREED! Mass isolation is unsustainable for much longer and has already caused deep mental, emotional, and socio-economic impacts. Our local, state and federal governments should be doing all they can to provide widespread testing for all, ASAP. If they are not moving toward this, then I truly suspect they have another agenda which has nothing to do with the virus in the end.

sacjon Apr 08, 2020 12:06 PM
COVID-19 Modeling Displays Importance of Social Distancing

Is it just me, or does anyone else want to know whether people who have been properly socially distancing and cleaning are getting infected? Wouldn't it be important and helpful to know that, despite all we're doing, people are still getting it? Or, what I'm hoping, that what we're doing IS helping and no one who is doing all this is getting it. Why can't they give us more info other than the numbers? We're all in this together and need to know whether all this sacrifice is actually working!

bosco Apr 08, 2020 03:51 PM
COVID-19 Modeling Displays Importance of Social Distancing

I don't believe that would be helpful. All you'll get is some anecdotal examples like the one below. And then people will use those one-off examples to bolster their opinions. This situation calls for large amounts of population data. There will always be people that get sick despite taking all the precautions and conversely there will be people that will stay healthy while taking no precautions. It's about the mean not the outliers.

sacjon Apr 08, 2020 03:51 PM
COVID-19 Modeling Displays Importance of Social Distancing

PUG - but they're not saying whether those who got infected were practicing social distancing. That is the info that would be helpful. Nothing is preventing them (legally at least) from telling us, in general, whether those infected have been keeping distance/staying home, etc.

Abc109 Apr 08, 2020 03:50 PM
COVID-19 Modeling Displays Importance of Social Distancing

@Pug, they are only "estimating" the percentage of people complying with social-distancing. I don't know about you, but everyone (and I mean EVERYONE) I know is complying. Where is the 40-50% "estimation" coming from? This is why we need hard data. We need models based on this hard data, not more models based on speculation.

SBRoses Apr 08, 2020 03:20 PM
COVID-19 Modeling Displays Importance of Social Distancing

This is entirely anecdotal but a good friend who lives in NYC and has not left her apartment except to visit the grocery store once now has contracted COVID and is on day 4 post diagnosis. She wore a mask and gloves, but mask was homemade - non-N95 - and no eye coverings to the store. Now her boyfriend who she lives with has also begun feeling unwell. The grocery store was the only place either of them had been in 2 weeks, and only she visited. She also mentioned the store was pretty crowded. I will ask her if she "disinfected" her groceries.

a-1590528953 Apr 08, 2020 02:47 PM
COVID-19 Modeling Displays Importance of Social Distancing

PUG - This isn't a HIPAA situation. HIPAA only protects information that you could identify someone with. This would just be letting us know if any infected people had been socially distancing and being vigilant about cleaning. Nothing would identify anyone, just whether anyone had been complying with the order.

Coolio Apr 08, 2020 11:48 AM
COVID-19 Modeling Displays Importance of Social Distancing

Everyone knows this disease is super contagious and can kill you especially if you're older and/or have health issues. If you discontinue the social distancing for economic reasons earlier than what data suggest and experts advise it will only cause cases/death rate to reemerge and soar.

Michele Apr 08, 2020 10:13 AM
COVID-19 Modeling Displays Importance of Social Distancing

"Adams went on to express his concerns about the economy and suggested finding the people with the greatest risk and isolating them, likening the situation to throwing out the baby with the bathwater." So rounding up and isolating everyone over 65 to get them out of your way? I understand it conceptually but jeez, that's so dark. And I bet there is more compliance with social distancing among the over-65's than among the younger people.

Sam The Dog Apr 08, 2020 10:52 AM
COVID-19 Modeling Displays Importance of Social Distancing

I believe the comment about the baby with the bathwater related locking everyone down to avoid the virus (bathwater) while destroying our economy (the baby). Isolating those at most risk is a way to not throw the baby out with the bathwater.

a-1590528953 Apr 08, 2020 12:04 AM
COVID-19 Modeling Displays Importance of Social Distancing

Have these experts taken into consideration that nearly 1/3 of confirmed cases are those who cannot practice social distancing? Inmates, first responders and health care workers have no choice but to be right in the mix. These numbers and models put out by PHD really are useless. With minimal testing there is no way to accurately predict where this will go. It is likely the numbers are way underrepresented and the spread is happening where social distancing isn’t. We know it works. All stores should be required to install plexiglass at checkout stands. Entry into stores should be limited and people should have to wait in their cars with a number. All prison staff should be quarantined near the prison and not have contact with their families or the public until the outbreak there is contained. We can do better.

Thomas John Apr 08, 2020 08:03 AM
COVID-19 Modeling Displays Importance of Social Distancing

Agree that we need and can do better. But I disagree with you knocking "models put out by PhDs really are useless". What are we supposed to do to predict what the upcoming weeks/months might look like? Yes, like the weather predictions none of these "models put out by PhD"s are spot on but they can provide some forecasting and hopefully help the powers that be deveople plans and policies for a better outcome.

a-1590528953 Apr 07, 2020 11:23 PM
COVID-19 Modeling Displays Importance of Social Distancing

I'm not so great with understanding these types of studies so question: does this study take into account the freeing up of ventilators as people are taken off of them, or does it assume a static number of ventilators? [same question for ICU and regular beds]. Or are the vents one time use only?

Ahchooo Apr 08, 2020 08:24 AM
COVID-19 Modeling Displays Importance of Social Distancing

It considers the balance between how many ventilators we have versus how many we need at any particular time. Typically, ventilators are cleaned and reused (I don’t know what the “disposables” are). The number of ventilators we have might change if we obtain more, but mostly it is static, while the need fluctuates according to how many people are very sick at one time. Often when covid-19 patients go on a ventilator they stay on for a couple weeks.

Marathoner Apr 07, 2020 09:41 PM
COVID-19 Modeling Displays Importance of Social Distancing

"Law enforcement is reporting an increase in close encampments ..." People need to scatter site camp not cluster at PATH or close-camped. Why not open up Earl Warren or something. We can even provide water, sanititation and army tents all much cheaper than leasing hotel rooms. Social distancing past spring will probably be much different no need to panic. What is so difficult about worship services on the church lawn, for instance, with six or more feet between parishionioners. No need to panic if you have to dip into your 10K for a couple months be grateful you're not sick, homeless or both.

GrammaSB Apr 07, 2020 08:10 PM
COVID-19 Modeling Displays Importance of Social Distancing

TO: LOOSECANNON I am a minority and live pay check to pay check what I meant was that money or no money you won't escape a possibly very bad ending. I don't stock pile and live within my means. I just wanted to create awareness across the board that our population vs availability of hospital care is worrisome. I as everyone else want this to be over soon and I am fearful of it as well. If I came across as a person of privilege I am not and I have health issues that are sensitive and regardless of socio economic status I have to deal with them. Have yourself a very blessed holy week and a nice evening stay healthy and safe.

Abc109 Apr 07, 2020 07:35 PM
COVID-19 Modeling Displays Importance of Social Distancing

@SBSurferLife, exactly re: the testing shortage. If everyone with symptoms were tested - or everyone at all - the hospitalization and death percentage would be way, way, WAY lower. Those are only confirmed cases. It could very well end up being that most cases in the general public are mild or asymptomatic, with many people simply being carriers. Until we get widespread testing for the virus and antibodies, this "you will die unless you stay locked in your homes" hysteria will continue. At the expense of us all.

Luvaduck Apr 08, 2020 09:02 AM
COVID-19 Modeling Displays Importance of Social Distancing

He meant if HE needed it. He's not complying or masking or standing apart, just gets tested repeatedly. Need I mention that those tests are in critically short supply. I get it--he's the POTUS and would get the best medical attention and supplies in the world. If he caught this through his carelessness, he'd have round-the-clock large staffs of docs and nurses and an entire hospital floor. He should set an example; people are dying.

sbmh2015 Apr 07, 2020 08:13 PM
COVID-19 Modeling Displays Importance of Social Distancing

I'm not sure what news you are watching or listening to, but your quote shows you are vastly misinformed. And it is not hysteria. This illness is very debilitating. It is not like a flu. Testing does need to increase but physical distancing is what is proving to work best.

SBsurferlife Apr 07, 2020 08:09 PM
COVID-19 Modeling Displays Importance of Social Distancing

That's one way to spin it. Drs have already said that most cases are asymptomatic or very mild. The issue is the small % of people who develop serious symptoms overwhelming the hospital system resulting in more deaths because they cannot receive proper care. Just like Italy. That's why we're staying indoors to prevent that from happening. Lack of tests, lack of hospital equipment, shortage of healthcare workers, etc etc. If it means we all have to stay indoors for a while to save lives, i'm fine with that.

a-1590528953 Apr 07, 2020 08:07 PM
COVID-19 Modeling Displays Importance of Social Distancing

The fact remains that we need to slow the rate of infection. I think we will see that the overall death rate is not as high as originally feared. But if everyone gets sick all in one month, some will die needlessly simply due to lack of medical care. Eventually we will all be exposed. But we need to be exposed slowly.

a-1590528953 Apr 07, 2020 06:42 PM
COVID-19 Modeling Displays Importance of Social Distancing

Just some observations on compliance with the request to wear masks: I donated blood today, and of the 11 donors that I saw, only two of us had masks. Then I went grocery shopping, and only one of the approximately 50 people I saw there did not have a mask.

GrammaSB Apr 07, 2020 07:21 PM
COVID-19 Modeling Displays Importance of Social Distancing

Yes the inconsistency around town is frustrating. There are communities that are actually putting out an ordinance for mandatory wearing mask in public and I believe today the Mayor of LA announced open essential businesses had to provide masks for employees or reimburse the employee for purchasing their own (non medical grade of course) AND if you are a patron they can deny you service if you don't have a mask on. I go out if absolutely necessary food or meds and wear gloves mask and hat, wash up upon returning home and as much as I hesitate do online purchases (Online aided in the loss of precious businesses). No visiting anyone and no visitors. We'll have one big celebration once this is over to make up for all our bdays, Easter etc etc Factories have come forward to fabricate non medical masks for sale to the public. They launched a COVID-19:Keeping Los Angeles Safe we page very informative.

GrammaSB Apr 07, 2020 06:29 PM
COVID-19 Modeling Displays Importance of Social Distancing

In doing the math for the estimated population for the communities that depend on Cottage Health System I added up the following 530,967 estimated population from Carp all the way to Buellton. 373 Actual Acute Care Beds with 127 being used currently planning on 270 surge beds which if all beds empty it is 643 acute care beds. There are, according to this report 50 ventilators available. All of you do the math and who wants to decide who gets the ventilator and hospital bed in the event of a dramatic surge. Who wants to tell the rest of the family that your loved one didn't make the cut for a ventilator. I know I am a broken record, but if SB gets this right currently it will make all the difference in the future and normalcy will be obtained sooner, the longer the current requests are met with resistance the longer it will take to reach normalcy. This virus doesn't discriminate, socio economic status doesn't matter it's basically first come first serve and then it goes by severity of symptoms what your level of care will be. The economy will bounce back, who ever can take advantage of the financial offerings currently should do it ie; unemployment, disability, FMLA, SBA. Talk to your creditors, your landlords etc. If you are in an essential industry as long as you are healthy and follow the guidelines keep working until otherwise instructed. Our communities health and well being depend on it. Before this pandemic there was a healthcare worker shortage now its worse the agencies that could be tapped into before such as traveling medical personnel are over extended and not all medically trained professional are able to crossover to critical care. If you are able order food from local places utilize the delivery services or quickly pick it up yourself. Lets be smart.

sbdude Apr 08, 2020 12:36 PM
COVID-19 Modeling Displays Importance of Social Distancing

I can copy and paste too. From today's LA Times: https://www.latimes.com/projects/california-coronavirus-cases-tracking-outbreak/#la-county "The highest rates thus far have come from predominantly white, affluent areas on the Westside..."

LooseCannon Apr 08, 2020 09:13 AM
COVID-19 Modeling Displays Importance of Social Distancing

Check your ASSumptions MATTYBOY: "Los Angeles Mayor Eric Garcetti expressed worry Tuesday evening that minorities and low-income residents are suffering most because they have a higher share of preexisting health conditions. Los Angeles County released preliminary information Tuesday that African Americans comprise 17 percent of deaths while they make up 9 percent of the residents." - Politico

LooseCannon Apr 08, 2020 09:10 AM
COVID-19 Modeling Displays Importance of Social Distancing

Here's some actual data, SBDUDE, just reported in the LA Times: "L.A. releases first racial breakdown of coronavirus fatalities; blacks have higher death rate." Maybe you and your sidekick need to check your facts and ASSumptions. (https://www.latimes.com/california/story/2020-04-07/l-a-releases-first-racial-breakdown-of-coronavirus-fatalities-african-americans-have-higher-death-rate

sbdude Apr 07, 2020 08:35 PM
COVID-19 Modeling Displays Importance of Social Distancing

@LooseCannon , You might want to check your data before yelling at others to check their privilege. In LA, the highest concentration of cases is in the Downtown - West Hollywood - Beverly Hills - Santa Monica corridor, some of the most wealthy areas on the planet. Similarly in San DIego, La Jolla, Rancho Santa Fe, Hillcrest, and Scripps Ranch have higher per capita rates than Chula Vista, National City, or El Cajon. Even in Ventura County, Port Hueneme and Oxnard both have *lower* per capita rates than Simi Valley or Thousand Oaks. Preconceived biases have a funny way of clouding over actual facts.

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