Thursday, February 20, 2020

Hospital in Spokane WA takes COVID19 patients because it is specifically equipped; related story about larger than reported numbers of people in US now under health department supervision

A Spokane WA television station reports that Sacred Heart hospital in Spokane (a “Catholic” hospital, and their hospital trade association was at one time a big client at Lewin when I worked for Lewin on simulating hospital Medicare operating margins) will treat five patients infected with COVID19.  
The TV station links to another story that reports on 700+ people are under health department supervision (as people under investigation).  Are these people supposed to self-isolate?  They are not part of the CDC outstanding cases, probably because they won’t be tested unless they have symptoms.  They don’t seem to be reported on CDC of Johns Hopkins yet.

As noted yesterday on the International Issues blog, it’s probably possible to have a close brush with the virus, develop temporary immunity, and then get a worse case months later if having a larger exposure (Antibody Dependent Enhancement, ADE). SARS behaved this way, as does Dengue (which is not a coronavirus).  It’s starting to look like a very large percentage of people who have community micro exposure to the virus will never have symptoms (maybe a cough for one day that goes away) and develop a minimal antibody response which may not persist.  A vaccine would need to keep the response permanent. This idea could relate to the "superspreader" problem, which sounds like science fiction.  
I’ve driven through Spokane once, in 1990.  By the way, if I heard from someone at Lewin who remembers me, that would be great.  It was an interesting job, in retrospect. Odd that their website (at least the home strike page) doesn't have https.  If I worked there now, they would.  
By Jdubman - Own work, CC BY-SA 3.0, Link

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