What We Know About Local Community Outbreaks – and What We Don’t - Voice of San Diego

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What We Know About Local Community Outbreaks – and What We Don’t

County officials say that most of the new coronavirus outbreaks have come from bars and restaurants – and so they have acted to limit the operations of those facilities. But they have not released information about the magnitude of the outbreaks.

A Communal Coffee employee prepares an order. / Photo by Adriana Heldiz

Repeatedly over the last two weeks, San Diego County has had enough new community outbreaks of COVID-19 to send us back into some form of lockdown – at least, based on 13 criteria unanimously approved by the County Board of Supervisors last month.

Seven community outbreaks within a seven-day period is one of three major triggers that allow San Diego’s public health officer to take wide-ranging action to try to stop the spread of the virus. Most recently, the county had 13 outbreaks within a seven-day period, and on Monday public health officials ordered bars to close.

The percent of positive cases and COVID-19-related hospitalizations have also been rising. San Diego will likely be added to a state watch list in the coming days, officials have said, which could trigger further business closures.

Based on limited data provided to the public, the rise in community outbreaks is still difficult to understand. County officials say that most of the new outbreaks have come from bars and restaurants – and so they have acted to limit the operations of those facilities.

But they have not released information about the magnitude of the outbreaks.

Out of 27 active and ongoing community outbreaks, nine have been traced to “businesses” or “workplaces,” according to data obtained by Voice of San Diego. Eight have been traced back to bars or restaurants, the data shows. And five have been traced to gatherings at people’s homes.

These do not include more than 40 ongoing outbreaks – which are in theory contained – in congregate living facilities, like nursing homes.

Officials have said that no outbreaks have been traced back to gyms or recent racial justice protests.

What the data doesn’t say is also striking.

“I’d want to know how many people are associated with each outbreak,” said Rebecca Fielding-Miller, who studies infectious diseases and public health at UC San Diego. “I would want to know what side of that space they were on. Were they staff or a customer? ‘Workplace’ is also an exceedingly broad category. So is ‘business.’”

Knowing these data points can help scientists and the public better understand the nature of the outbreaks and what should be done about them, she said.

Voice of San Diego has requested more specific data from the county, but has only received a list of outbreaks that includes broad categories, such as “business” or “restaurant,” and nothing else.

To be considered an outbreak, at least three people from separate households must test positive for COVID-19. That means every outbreak on the list is responsible for at least three positive cases.

But beyond that, it’s impossible to know the magnitude of each outbreak. Are “businesses” causing the largest flare-ups? Is it parties at people’s houses?

Another data point that would be useful would be the age demographics for each outbreak, said Fielding-Miller. That could help researchers begin to understand if children – even when asymptomatic – are actually powerful transmitters of the virus or not.

There is, however, a need to balance privacy with the public’s right to know, said Fielding-Miller.

“You do not want to expose restaurants or people’s houses and risk having those places be labeled as a plague house,” said Fielding-Miller.

This echoes the message from county public health officials, who have previously declined to give specific locations of outbreaks, such as certain restaurants or grocery stores.

Dr. Eric McDonald, the county’s chief epidemiologist, has said that his team works with any locations that have experienced an outbreak to make sure that they sanitize their facility properly and shut down if they need to. That is enough, he said, to make sure those locations are safe and ready to use again.

Still, Fielding-Miller said the county needs to release more data both for scientists and the public.

“We want all the data,” she said. “There is not any data I don’t want, as a scientist … We want all the data we can get.”

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