Tuesday, April 21, 9:31 AM

April 21, 2020

Good morning everyone, looks a little cloudier through the basement window this morning after a string of amazing weather.

Administrative Professionals “Day” will be today and tomorrow, thank you all! This is a fun event every year in the Dean’s office and an opportunity for us to thank our administrative professionals for everything they do. Heather and the office staff think about what to hand out (remember the uneven Rubik’s Cubes?) and get it all together, then Lisa Ferrin and I grab everything and go around campus trying to see and thank as many people as we can in person. We go through Casey, then do a clockwise loop around campus. A couple of years ago there was a crazy hailstorm that hit while we were between the Fine Arts Building and the Lynn Building. That year is much more fun in hindsight. This year we won’t get to see you in person and we’ll miss it but I am going to try to call and reach you (or leave a message) through Microsoft Teams. If I end up leaving a message instead of talking to you over the next few days, please know we are thinking of you and deeply appreciate your contributions.  

There is a 3-question survey being sent out to students across the university about their online course experience so far; it will not be used for faculty evaluation. This survey was distributed centrally with the goal of getting a sense of how online instruction was going from the student perspective, but it will not be part of any faculty evaluation process. I have already provided some feedback about the content and rollout of the process in a way I hope is helpful moving forward.

COMMUNITY UPDATES – No big new information that I have seen in the past 24 hours here. 

Mike Myint Update: Mike says we are just entering the “difficult middle” and mentions what is considered the gold standard in testing. He also links again to the aggregated data site he has referenced in the past.

Informing Decisions in the "Difficult Middle"

If you look at the daily graphs for new cases and deaths, it does appear that the world has reached a plateau in the setting of extraordinary physical distancing measures. Know that in certain countries, especially resource constrained countries, we are vastly undercounting due to testing being the numerator counted. Remarkable as it is, the modelling for the exponential part of the curve was the "easy" part. Modelling the next phase will have to take into account many more factors than simply bacterial doubling time and social distancing to decrease the Ro value.

This is uncharted territory but unfortunately (or fortunately if you are a sociologist) we have a natural experiment across the globe and in 50 states on the different interventions and the effectiveness of these differing policies/practices. Climate, population density, policy, public adherence to policy, and luck will play into regional variation for the next 6-12 months.

The data available on websites like this one, Hopkins, and others, will continue to inform. At our hospital level, we look for triggers both in the community/region as well as internally to our system, to try and determine how much we can resume operations for non-urgent/emergent procedures. But there is no consensus and guidance is lacking with the unprecedented nature of this pandemic. PPE is still constrained, though improving.

Testing, though still lacking, is only the first step as a solution. RT-PCR testing, still the gold standard, is still limited in the US. Serology, that is, testing to see if people have antibodies showing possibly current or past infection, is not appearing to be particularly helpful with the first generation of tests.

IDSA COVID-19 Antibody Testing Primer (PDF)

Putting these together with more local or individual physical distancing/quarantine and support, as I have previously pointed out, is the rational but difficult path forward as it is difficult to recover from years of under-investment in such a short period of time.

The good news is that we know what works. Physical distancing is uncontroversial, but being able to restart businesses in a way that protects the workers, and the most vulnerable members of our population is why I refer to this period before safe, effective treatments or vaccines as the difficult middle.


Our World in Data