I had a some sassy salad with a vegetarian burger for dinner. The sassy salad appears to be a mix of different greens; I have seen something similar at the grocery store that is called 'spring greens'.
The Roommate Who Likes to Wash Dishes also likes to make carb-rich desserts; tonight it was chocolate chip & peanut butter chip cookies. I ate one because it is my carb cheat day. I also saved one for Wednesday, which is a keto-carb cycling day. Sometimes he makes brownies and sometimes it is just plain chocolate chip cookies.
I unplugged the old Mac at about 10 this morning to see how long the battery lasts right now. It was still doing okay when I was getting ready for bed. I will check it again tomorrow morning to see how it's doing. (I thought I took a photo but can't find it.)
There is a disturbance about 500 miles south of us. It is slowly moving westerly at about 5 to 10 mph and has been given only about a 10% chance of forming a storm over the next 5 days.
The California Health Care Foundation has a great article about contact tracers and the complexities of the job. It further points out how you can't just put anyone in the position without training. Our situation here is similarly complex with all the languages spoken here, though I think there are fewer undocumented immigrants here; just a lot of forcibly displaced people whose homes were destroyed & made unlivable for the rest of their lives by radioactive testing by the US during the Cold War. And we (the US) has the audacity, even in this pandemic, to deny them healthcare coverage because they are not US citizens! Auē!
Like with undocumented immigrants, the refusal to provide healthcare coverage for these non-citizens is a gaping hole in the ability for public health measures to stop disease transmission; similar to the refusal in some areas to provide drivers licenses. Withholding these things just makes things less safe for everyone in the community, red and blue alike. SARS-CoV-2 doesn't know what your politics are, it just knows you are a live body that it can replicate itself in and spread to other warm bodies!
While we're on the subject of things that irritate me, what about the racism in COVID-19 coverage in the media? No, I don't mean the higher rates of COVID-19 in people of color & low income than their representation in the majority 'white' population of a country. I mean the larger issue of how countries that are not predominantly 'white' but are successful at controlling outbreaks and limiting deaths, are not perceived to have the competency to be able to do that. Instead, the successes are attributed to genetics or that it is unexplainable!
For example, have you heard about how Taiwan responded? Click on the link to watch an interview with Taiwan's vice president (an epidemiologist) to see how they contained the COVID-19 outbreak. VP Chen also talks about the role of contact tracers & quarantines. And by the way, single payer health care also played a role. There was no lock down; businesses stayed open, schools stayed open. However quarantine was very strict; 14-days of total lack of freedom for a few (~500) allowed for normal levels of freedom for the vast majority (23.6 million), economic stability for all, and less than 10 deaths.
I have mentioned the Department of Health's dashboard prototype and also said I wasn't really using it because I did not think it was really useful due to the gaps in data. The prototype was released on September 4th, the last day of the Cohort 2 contact tracing training, a little over 2 weeks ago. At that time Civil Beat noted that the new dashboard had been promised at least since August 6th. They also noted that it was still missing metrics and there was no timeline given as to when those would be added. The state still chose to make it widely available without making it clear that there was still a bunch of missing data.
Below I have looked at each metric on the prototype dashboard, noted whether the data was current, and also noted whether it is a leading or lagging mitigation indicator; if the metric is not on the figure below I made a guess as to which end of the spectrum it would be. The information provided by leading indicators can help slow the spread of a disease; lagging indicators just tell you what happened after the disease broke out in the community.
The dashboard still clearly says it is a prototype and the banner still annoyingly stays fixed to the upper half of the page decreasing how much of the dashboard you can see at one time. The Mask Wearing data (leading) is interesting; I'm not sure where data is coming from since the only reference listed is from a July study. And these numbers do not match another Mask Wearing graphic listed later in the dashboard; so I would not trust this data. The Epi Curve (neutral) appears to be OK but you can't see the entire graphic in its entirety due to the annoying banner. Also, if they continue to present all the data from the very first case in March, the change in scale on the x-axis will make the y-axis appear extremely high during the surges; it would be more meaningful to present a shorter time frame, perhaps a rolling 3-month chart or to spread it across the width of the page. I assume the Hospitals data (lagging) is accurate since I have no way of checking, but in the week prior it showed COVID-19 patients using 225 general beds (40 more than this week), 53 ICU beds (2 more), and 31 ventilators (9 fewer). There is no information that says whether there is an overlap in ventilator use and ICU beds; I would assume if you need a ventilator, you also need to be in the ICU, but it doesn't say. The Mobility (assumed neutral) data is too small to be seen easily; there is a larger further down the dashboard that is slightly better but they should make it spread across the entire page to be useful.
I deleted the banner from the rest of these screenshots. The Statewide Testing (neutral) follows other data sites and is updated almost daily. The information on New, Active, and Cumulative Cases (neutral) is OK but consistently a day behind. I can't really tell whether the DOH Isolation/Quarantine Facilities (assumed neutral) data is good because there is no where for me to fact check it. The Fatalities (lagging) tracks with other data sets and is updated daily.
The number of Contact Tracers (somewhat leading) has never been this high in any other published information. The header says this table is for the "week of 9/7"; the data released on the main DOH website for the week of September 7 - 13 says there were a total of 256 contact tracers in the state with 150 on O'ahu, 24 on Kaua'i, 42 on Maui, and 40 on Hawai'i Island. I do not trust the data in the prototype. The HIPAM Forecast is confusing; is the dark line labelled "Expected" the forecast and the red line is the actual outcome? If so, we are not doing very well at flattening the curve! The Inbound Travelers (assumed lagging) appears to be OK but it is missing a big component to make it a somewhat leading indicator: place of origin. The PPE has not been updated since the prototype was unveiled, I would not trust this data.
The External Risks and US Epi Curve come from other nationally available dashboards.
Both of these graphs are at the top of the dashboard but in a much smaller format making them difficult to use. And the Mask data here is not consistent with the Mask data at the top of the dashboard; I would not rely on the Mask data.
The testing data (neutral) is OK and updated regularly. The Cluster data (somewhat lagging) is from 08/27 has not changed so it is more misleading rather than useful; it should be updated at least weekly to be of any value.
The Timeliness of Contact Tracing (somewhat leading) really needs to be tracked and presented to everyone! If you watched the video about Taiwan above, you know how important quick & thorough contact tracing was in keeping their transmission rate and number of new cases, and subsequent fatalities low. The Testing Turnaround Time (somewhat leading) is not broken out by in-state vs out-of state labs so it is misleading. Quick turnaround times are an indicator of capacity to do tests in a timely manner; the faster a test result is returned, the sooner infected people & their close contacts can be notified and placed in isolation or quarantine to cut the transmission rate.
The Hospitalizations data (lagging) seems to be OK; due to the scale I can't really tell whether it is consistent with the table at the top of the dashboard as I was with the mask data. I am sure the state has data manager's who know a whole lot more than I do about how to best present data to be useful; I just go by what I found to be helpful in explaining things for my work. I wonder why a better dashboard with better metrics is not being presented.
One of the things that I find most annoying is that the Notes regarding how & where the data was collected still has the date of 09/03, the day before the prototype was shown to the media. It has not been updated at all. Any assumptions they have made regarding the display of data may also be out of date. The bottom line for me is that they should not allow the prototype dashboard to be readily available until all metrics are available in a timely manner; all the data that is regularly updated on the prototype is available elsewhere. And a lot of the other data is in a much more user-friendly format; a number of them are below.
There were 77 new COVID-19 cases reported today, bringing the total known cases up to 11,403; there were no new deaths. I haven't shown you this map in a while; you can see the Hilo area lit up in red with all the cases and deaths at the veterans nursing home there.
Hauʻoli lā Hānau e Dale & cousin Steve! A me ka Hauʻoli lā Hoʻomanaʻo e Rebecca & Bill!
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