COVID-19 Response: Review of Metrics Adopted to Monitor Community Disease Spread Presentation to the Board of Trustees August 25, 2020 Presented by the Leadership Team 1 Attachment A - Updated
Reopening Schools • Guiding Principles o A ll decisions based on a foundation of “Do No Harm” o Ensure student, family, and staff basic needs are being met o Ensure equitable access for all students o Maintain high academic expectations for all students o Follow as practical all federal, state and local health related guidelines 2 2
Presentation Objectives • Building from the August 11 th Board of Trustees action regarding metrics, a description of proposed metrics and how they can be used in combination to monitor the spread of the COVID-19 virus, and how that can impact learning model choices. • Provide possible actions to the Board of Trustees for their consideration and possible adoption. 3 3
A Step Back — Review of Practices • Public Health Surveillance for COVID-19 (August 7, 2020). The World Health Organization. • Surveillance and Data Analytics: The Latest in COVID-19 Data and Surveillance (June 29, 2020). Center for Disease Control and Prevention • CDC Data Dashboard (https://www.cdc.gov/covid-data-tracker/index.html#trends) • Key Metrics for COVID Suppression (2020). Harvard Global Health Institute • Key Metrics for COVID Suppression: A Framework for Policymakers (July 1, 2020). Harvard Global Health Institute. • UC Davis Interactive Dashboard (https://www.ucdavis.edu; https://covid19.calsurv.org) • John Hopkins University Data Dashboard (https://Systems.JHU.edu; https://www.arcgis.com) • Truckee Meadows Threat Meter Draft website: (http://tmrpa.org/covid-wc/) • Nevada Department of Health and Human Services (https://nvhealthresponse.nv.gov/) • Washoe County Health Division (https://gis.washoecounty.us/COVID19) • Department of Homeland Security (Various Reports) 4 4
The World Health Organization (WHO) • As it pertains to disease surveillance, the WHO recommends monitoring using multiple indicators. • These include but are not limited to: • New cases on a daily basis • Deaths on a daily basis • Cumulative cases and deaths • Testing rates (*the WHO does recommend that test positivity be at or below 5%) • In order to properly surveil disease spread, the WHO emphasizes clear and consistent variable definitions (e.g. confirmed and probable cases, contacts). • It further emphasizes the need to report quickly based on newest available information, and by location. • The WHO points to the critical need of contact tracing as an element of surveillance, as well as a factor to mitigate disease spread. 5 5
Centers for Disease Control & Prevention (CDC) • The Center for Disease Control and Prevention (CDC) provides very similar guidance to that provided by the WHO. • In terms of surveillance, the CDC does distinguish between disease incidence, prevalence, hospitalizations, and mortality. • Toward this end, the CDC recommends and uses the same metrics being used by the WHO and adds metrics (e.g. 7 day rolling average of new cases). • The CDC does report state level data through its COVID Data Tracker (https://www.cdc.gov/covid-data-tracker/index.html#trends) 6 6
CDC (Total Cases & Test Positivity) 7 7
CDC (Trend in Cases) 8 8
CDC (Trend in Deaths) 9 9
Centers for Disease Control & Prevention (CDC) The Importance of Reopening America’s Schools this Fall (July, 23, 2020). Centers for Disease Control & Prevention Aside from a child’s home, no other setting has more influence on a child’s health and well -being than their school. The in-person school environment does the following: • provides educational instruction; • supports the development of social and emotional skills; • creates a safe environment for learning; • addresses nutritional needs; and • facilitates physical activity. Consideration for Schools (May 19, 2020). Centers for Disease Control & Prevention Implementation should be guided by what is feasible, practical, acceptable and tailored to the needs of each community. Measures to reduce spread: self screening, hygiene, face coverings, visual cues, cleaning, ventilation, spacing/seating, sharing of materials, outbreak response, etc … 10 10
Harvard — Global Health Institute Metric 1 : New confirmed case trend: New daily cases per 100k pop (seven day rolling average); + trend direction & rate Metric 2 : Case trend as an estimate from new deaths trend: New daily deaths per 100k pop * 100 (assuming 1% IFR) (seven day rolling average); + trend direction & rate Metric 3 : New daily hospitalizations per 100k pop (seven day rolling average); + trend direction & rate COVID Risk Level Case Incidence Red > 25 Daily Cases Per 100,000 People Orange 10 < 25 Daily Cases Per 100,000 People Yellow 1 < 10 Daily Cases Per 100,000 People Green < 1 Daily Cases Per 100,000 People 11 11
UC Davis & John Hopkins University • UC Davis has built an interactive website that displays both state level and county level data (county level maps not currently available). They are displaying: • Confirmed Cases & Deaths • Cumulative total • Cases/deaths per 100,000 • Daily new cases/deaths • Total tests and daily test administered • Total hospitalizations and new daily hospitalizations • John Hopkins University is reporting at a state and national level including: • Total cases, and daily new cases • Total deaths and daily new deaths • Recoveries 12 12
Truckee Meadows COVID Threat Meter Please review our draft Truckee Meadows Threat Meter website Draft website: http://tmrpa.org/covid-wc/ Please review our draft threat-level guidelines on the next pages • Please provide comments and/or edits about the website or any information in this PowerPoint to Jeremy jsmith@tmrpa.org 13 13
Truckee Meadows COVID Threat Meter Green: Minimal to no COVID-19 activity in the community . Gathering is allowed at pre-pandemic levels according to government recommendations. Follow any state mask recommendations. Yellow: There is consistent disease in the community, yet it is under control. Risk for community spread is increasing, but moderate. Avoid large gatherings. Consistently wear masks in public and with at-risk people. Strongly consider not going to gatherings unless for an important or essential purpose. Orange: COVID-19 risk in the community is becoming dangerous Risk is becoming critical. Case numbers and impact on hospitals are increasing. Only leave your home for essential functions such as work, obtaining food, etc. Consistently wear masks in public. Stay away from at risk people. Socially isolate as much as possible. Red: Lockdown mode At this stage our community is in crisis mode. Our case numbers are critically high and our hospitals are at or near capacity. Shelter in place. Don’t leave your house unless you absolutely have to. Strict mask compliance outside the home. 14 14
Truckee Meadows COVID Threat Meter • The 4-level risk meter rating is determined through the use of 5 metrics each with a score range from 0-3, resulting in a range of 0-15. The metrics include: • Risk Assessments → Measures the slope in completed risk assessments over the previous 14 days. • Test Positivity → 7-day average of test positivity. • New Daily Cases per 100,000 → 7-day average of new daily cases, normalized by population. • Medical Interventions Due to COVID → % change in 7-day average compared to previous 14- day average (hospitalizations and ICU). • Hospital Capacity → 7-day average in hospital bed use and ICU bed use. 15 15
Governor Sisolak’s Plan 16 16
Governor Sisolak’s Plan 1. Average Number of Tests Per Day (per 100,000) < 150 • Average # of tests daily during previous week, converted to rate per 100,000. • Reported over a 14-day period with a 7-day lag. 2. Case Rate (per 100,000) > 200 • Total # of cases over a 30-day period, converted to rate per 100,000. 3. Case Rate (per 100,000) > 50 and Testing Positivity > 7% • Case rate calculated as above. • Positivity is the number of positive molecular tests divided by the total number of molecular tests administered. • This is reported over a 14-day period with a 7-day lag. 17 17
Governor Sisolak’s Plan • Counties are evaluated based on these criteria • 0 of 3 = Low Risk • 1 of 3 = Growing Risk • 2 of 3 = Moderate Risk • 3 of 3 = High Risk • Based on risk level, the Governor recommends various mitigation strategies. • It is noted in the document that for school separate criteria and mitigation strategies apply. • Governor Sisolak’s Directive 028, and associated Nevada Department of Education guidance, requires school districts to monitor state and local data and to work with their local health divisions when considering changes to learning models. 18 18
Federal Incident Report & Governor’s Report • White House Governor’s Report had listed Nevada as in the Red Zone, but Washoe County in the Yellow Zone • Red Zone = Greater than 100 cases per 100,000 & a Test Positivity rate at or above 10% using 7-day rolling average. • Washoe County was Yellow because its Test Positivity rate was below the 10% threshold 19
Washoe County Dashboard 20 20 19
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