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Dr. Matyas responds to my request for daily updates on TOTAL hospitalizations since the pandemic began
By Roger Straw, September 28, 2020
Background
Roger Straw, The Benicia Independent
On September 24, I wrote to Dr. Bela Matyas, asking him to restore a TOTAL count of COVID hospitalizations since the pandemic began:
Please consider this request: From the earliest days of the pandemic and through July 10, the County’s COVID dashboard showed Total Hospitalizations.
Beginning on July 13, the dashboard only shows Current Hospitalizations. The daily change in Current Hospitalizations must be the difference between admissions and discharges, plus or minus, which is important to know.
However, the public needs to also know how many NEW admissions on a daily basis in order to accurately understand spread. This can easily be seen in the daily update of Total Hospitalizations.
Please consider restoring Total Hospitalizations to the COVID dashboard.
Dr. Matyas sent the following reply on September 27:
Dr. Bela Matyas, Solano County Public Health Officer
“The daily change in total hospitalizations does not faithfully represent new hospitalizations; the majority of added hospitalizations day over day is from reconciliation of previously hospitalized cases that we learn about in arrears. It is likely to be a substantially under-reported number.
Hospitalization is not a reportable condition on an individual level; hospital capacity is the condition that we are monitoring, and total hospitalizations per day is the relevant metric. Reporting total hospitalizations to date on a daily basis would be a misleading indicator for tracking new hospitalizations both because of the timing of reports and the under-reporting of hospitalizations.”
My response today:
Dr. Matyas – Thank you for your response to my email. With respect, I think I disagree. Regardless whether a daily update of TOTAL hospitalizations since the outbreak began includes ONLY new hospitalizations TODAY or both new TODAY and “newly learned in arrears” hospitalizations, the metric of total hospitalizations (and a 7 or 14 day average graph showing the curve of that metric) would be of great significance in understanding the overall spread of the most serious cases.
This daily increase, whether learned in arrears or not, is important for the public’s awareness. MOST IMPORTANTLY, reporting on hospitalizations in this way might help in cautioning the public to take seriously the continuing need for masks, social distancing, hand washing, etc. As our public health officer, I’d hope you might stop and think about this again. Seems it wouldn’t hurt the cause at all to add this metric to the County’s COVID dashboard, and shouldn’t be too hard to calculate the data as I have been doing, working from the AGE GROUP data.
I will continue to add together the newly reported daily reported increase of hospitalizations in the AGE GROUP data in order to determine the daily increase in TOTAL hospitalizations. And I will continue to let the public know.
Roger Straw
Benicia
Click the image for Solano County COVID-19 Updates and Resources
(Chris Riley/Times-Herald) The city of Benicia was given a shelter in place alert and areas south of the Valero Refinery were evacuated after a power outage caused a flare up sending plumes of black smoke across Interstate 680.
By Grant Cooke, Benicia Resident and President Ag Tech Blends, September 24, 2020
Grant Cooke
I recently warned that Benicia faces a self-induced calamity. If the town doesn’t come to grips with the reality that it’s game over for the oil industry and that the tax revenue from Valero will end, the town’s future will be grim.
I suggested that by mid-century most, of it not, all Bay Area refineries—Valero included—would be shut. It may be sooner, as recently, Governor Gavin Newsom announced an executive order that would phase out gasoline-powered cars and pickups by 2035.
Most likely the big oil companies will do their best to delay this, but the direction is clear, California is turning away from fossil-powered vehicular transportation. Electric and hydrogen powered vehicles will be the norm sooner, instead of later.
The impact on Benicia and the other towns—Martinez, Rodeo, Richmond—will be significant. Unless those towns plan ahead—a troublesome chore for municipal governments—services will be drastically cut.
Secondly, if the refineries lock the gates and walk away, the cities will be stuck with the bill for cleaning up the hazardous waste that has accumulated for decades on the refinery property.
A couple of other points to consider. The first is the horrendous conflagrations that are besetting our state. Anyone who lives in California and doesn’t accept that climate change is real and life-threatening needs to talk to some of the state’s farmers who live that reality daily. Farmers know the weather and they know the ravages they are facing as the climate changes.
Climate change is not complex. It is caused by excess greenhouse gases caused by excess fossil fuel use. School kids can explain it.
The second is further from Benicia, but relevant. Over the last few weeks, a peace accord has been struck between Israel and the United Arab Emirates. Now Bahrain has joined and eventually Saudi Arabia and Iraq will also.
This is something I never dreamed I would see—peace in the Middle East. After all the trillions of dollars spent, the tragic deaths and wounded US soldiers, the horrific dismemberments by ISIS, and the millions of civilians who lost their homes, villages or lives; the wars are ending.
The stated reason for the accord is that the moderate nations are sick and tired of the Sunni and Shia extremists and decided that working with Israel with its military might and US backing is the lesser of two evils. These guys are ever pragmatists.
On the other hand, the unstated, but probably more significant reason, is the moderate nations, particularly UAE and Bahrain, have leaders who understand that they have to move away from oil-dependent economies. With a growing population of well-educated, underemployed and potentially restless citizens, change has to happen. The Middle East needs economic diversification with renewable energy, science, modern Western technology, risk capital and innovative thinkers, or the moderate nations are doomed.
This too is Benicia’s dilemma. Basically, the city is a mini petrostate with 45 percent of its tax revenue coming from Valero or related businesses. The city’s problem of dependency on oil tax revenue is the same as the Middle East nations, or Louisiana, or any other municipality that fails to plan for a non-carbon world. At least UAE and Bahrain have come to that realization.
If UAE and Bahrain can think this through, maybe Benicia can. The first step is to resist Valero’s and the union’s PAC to take over the city government in the November election. If the town’s oil interests and supporters control the city, planning for a diversified tax base won’t happen.
Vote for Steve Young and anyone else who is willing to refuse campaign contributions from Valero and the union PAC. That’s a simple step.
The next steps are going to be harder. The first is to bring the problem out in open. Ask Valero for their plans as the oil refinery winds down. What will be the decline in tax revenue? How much have they put aside for environmental cleanup? How many of their folks live in Benicia and what will be the job losses?
Supposedly, Valero says that it will be the “last man standing” or the final oil refinery left in the Bay Area. I doubt it. My bet is that Chevron in Richmond will hold out the longest because their corporate headquarters are in the Bay Area. Valero is a Texas company, which probably means they will be one of the first to shut.
The second step is that Benicia has to do what Bahrain is doing, namely diversify the tax revenue by moving from a fossil fuel to a knowledge-based economy. The world is full of examples of cities—Bristol, Vancouver, Melbourne, Singapore, come to mind—that have remade their economies.
There are several examples in the Bay Area—San Francisco, Walnut Creek, Livermore and Pleasanton.
The third step is probably the hardest still. The move to a robust knowledge-based economy with science, technology and innovation to produce wealth should be sub-regional—along the Straits. Benicia is going to have to cooperate with Vallejo.
Wealth is being generated all along 680 and both cities have to adapt quickly, or they will be left behind as Fairfield and Vacaville prosper by growing their knowledge and service-based economies.
Unfortunately, Benicia and Vallejo have flaws and neither has the ability to generate significant change. They do, however, have exceptional geography with beautiful waterfronts and spectacular views. They have more potential than other underdeveloped Bay Area cities, except maybe Richmond.
But neither can develop a robust new economy by themselves. They don’t have the resources or the willingness to overcome the differences that serious change requires.
There are no easy answers for remaking a city’s economy. It takes vision, hard work and a united citizenry with common goals and a willingness to change. Cities are like alcoholics; they usually don’t change their behavior until they reach rock bottom, or their livers give out.
The cities I mentioned that were able to remake their economies had remarkable good luck when a new company suddenly boomed—like Pleasanton with People Soft—or a brilliant and powerful leader like Willie Brown in San Francisco, who could wrench the existing power structure into action.
It is particularly hard for a small town like Benicia that has prospered along with a single industry and has a city council with decent folks but split agendas. Heaven knows there are small company towns—like Benicia—throughout the Rust Belt that are dead or dying because they waited until the gates were locked and the pink slips issued. Look what happened to Detroit.
The Bay Area is maybe the world’s center for science, technology, innovation and risk capital. It is an unparalleled combination that is being copied in China and on a smaller scale in Boston and Copenhagen. The mixture creates wealth like mountain snow creates mighty rivers. Despite the trillion-dollar successes of Apple, Google, Facebook and Sales Force, this era of magnificent knowledge-based companies is just starting. There are untold new wonders to be developed and decades to run.
It would be a pity if Benicia fails to participate.
####
Grant Cooke is a Benicia resident and co-author of two books:
By Woodrow Clark II and Grant Cooke, published by Elsevier and available at Amazon:
State will assemble a “review board” of leading scientists
FILE – In this July 27, 2020, file photo, Nurse Kathe Olmstead, right, gives volunteer Melissa Harting, of Harpersville, N.Y., an injection as a study of a possible COVID-19 vaccine, developed by the National Institutes of Health and Moderna Inc., gets underway in Binghamton, N.Y. A letter from federal health officials instructing states to be ready to begin distributing a vaccine by Nov. 1 — two days before the election — has met, not with exhilaration, but with suspicion among public health experts and others. (AP Photo/Hans Pennink, File)Vallejo Times-Herald, By Lisa Krieger, September 26, 2020
California will conduct its own independent review of potential COVID-19 vaccines, signaling its distrust of the Trump administration’s accelerated “Operation Warp Speed” initiative.
To vet a vaccine before distribution to state residents, California Health and Human Services Secretary Dr. Mark Ghaly said Friday that the state will assemble a “review board” of leading scientists at academic institutions to assess the safety and effectiveness of any vaccine candidate.
“We think it is an appropriate approach to take, especially because things are moving so quickly,” Ghaly said. “We want to make sure — despite the urge and interest in having a useful vaccine — that we do it with the utmost safety of Californians in mind.”
The announcement came at a press conference in which Ghaly also expressed concern that California’s coronavirus numbers are beginning to move in the wrong direction after weeks of declines. Based on current trends, he projected an 89% increase in COVID-19 hospitalizations over the next month. That would still be far below hospital capacity and the worst rates in other states.
On the vaccine testing issue, several other states, including New York, have signaled that they’ll also take the unusual step that Ghaly outlined.
“Frankly, I’m not going to trust the federal government’s opinion, and I wouldn’t recommend to New Yorkers, based on the federal government’s opinion,” New York Gov. Andrew M. Cuomo announced at a Thursday news briefing, according to the New York Times.
President Trump has insisted a vaccine will be ready as early as next month, an assertion that other federal authorities say is unlikely.
California is already building a rollout plan for distribution of the vaccine, including whom to prioritize in the process, said Ghaly.
Led by the state’s Department of Public Health, members of a new Vaccine Task Force include other state agencies, as well as academic experts, community groups and individuals.
Once the state confirms the safety of the vaccine, this task force will advise distribution “in an equitable and smart way, to serve all the needs of Californians,” said Ghaly. “That absolutely is our plan.”
Conflicting information about the timing of the vaccine and whether it will be safe and adequately tested has created growing concern that people are hesitant to take it, despite its importance in stopping the pandemic.
The share of Americans who say they would get vaccinated for the coronavirus has declined sharply since earlier this year, according to a survey conducted this month by the Pew Research Center. About half of U.S. adults (51%) now say they would definitely or probably get a vaccine to prevent COVID-19 if it were available today, down from 72% in May.
Only about 21% said they would definitely get a coronavirus vaccine, half as many as in May.
While it is the federal government’s role to approve a vaccine, states have authority for actual distribution — and could, in theory, reject a vaccine they think is unsafe.
“Each state, indeed, has that sort of responsibility,” said Vanderbilt University’s Dr. William Schaffner, an internist and infectious disease specialist who formerly worked for the U.S. Public Health Service and the Centers for Disease Control and Prevention, at a Sept. 24 National Press Foundation program. “Some may be more ready to independently evaluate the data than others.”
An FDA committee — called the Vaccines and Related Biological Products Advisory Committee comprising 15 authorities selected by the FDA commissioner — reviews the safety and effectiveness data at a public meeting. The FDA commissioner usually follows the committee’s recommendation, but not always.
Typically, states follow the decision of the Advisory Committee on Immunization Practices, or ACIP, an independent committee that assesses data on FDA-approved vaccines and makes recommendations to the CDC.
But there is growing worry that the federal regulators may feel pressure from the White House to activate “Emergency Use Authorization” of an unlicensed vaccine, which would not require completion of a full “Phase 3” trial, during which efficacy is tested in thousands of people.
Two other COVID-19 products — hydroxychloroquine and convalescent plasma — received emergency use authorization, and have been touted by President Trump, despite little or no evidence of effectiveness.
This week, the FDA said it would enact new guidelines to toughen the process for approving a coronavirus vaccine. But President Trump said on Wednesday that the White House “may or may not” approve the plan, saying it “sounds like a political move.”
Saying they were “alarmed by political interference in science amid the pandemic,” the presidents of the prestigious National Academy of Sciences and National Academy of Medicine issued a statement on Thursday warning that “our nation is at a critical time in the course of the COVID-19 pandemic with important decisions ahead of us, especially concerning the efficacy and safety of vaccines.”
According to the Capitol Hill-based Roll Call, seven jurisdictions have indicated they would analyze the data independently: California, Colorado, the District of Columbia, Michigan, New York, Oregon and West Virginia. Another two — Montana and Wyoming — said they’d only administer a vaccine that completed clinical trials and an outside committee’s review.
“States are nervous. We’re talking about this now,” Marcus Plescia of the Association of State and Territorial Health Officials told Roll Call. “I think that a lot of public health officials in the states are concerned, given the rhetoric from the administration indicating they want a vaccine as quickly as possible.
But a state-by-state approach — for instance, if one state allows a vaccine, but another state does not — could complicate the pandemic response, which already varies greatly among states, said one expert.
While trust and confidence in the federal agencies has been shaken recently, “that is not the way to get control of this virus,” said Dr. Howard Koh, professor at the Harvard T.H. Chan School of Public Health, in a Sept. 16 media briefing. “Whenever a vaccine approval occurs, that needs to be accepted by the country, across the country, with implementation as a country.”
As to California’s numbers, Ghaly said Friday that the state is seeing upticks in case rates and hospitalization rates in some counties. They are small now but enough that the state is forecasting that 4,864 people will be hospitalized with COVID-19 by Oct. 25, an increase of roughly 89% from Wednesday, when there were 2,578 patients.
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