Scripps Data Experts Team with Columbia Researchers to Evaluate Phase 3 Reopening Last Summer

Modeling study looked at effects of business reopenings, restrictions

Three medical professionals in full PPE care for a patient with coronavirus in a hospital room at Scripps Health.

Modeling study looked at effects of business reopenings, restrictions

Scripps Health data experts have teamed with Columbia University infectious disease modeling scientists to estimate how the number of coronavirus deaths and hospitalizations at Scripps might have been different had a 25-day reopening of businesses not occurred in San Diego County last summer.

The researchers concluded that 45 deaths, or nearly two deaths a day, could have been avoided at Scripps’ five hospital campuses alone had the pandemic restrictions remained in place. These findings mirror recent conclusions by some experts nationally that more lives could have been saved had restrictions been put in place earlier and for a longer period during the pandemic. The findings also validate efforts that help to minimize the spread of the virus, such as wearing masks, practicing social distancing and avoiding large gatherings.

“Our research shows that community restrictions work, and that message couldn’t be any more important than now as federal health officials warn that a fourth COVID-19 surge could be around the corner if we let our guard down too much and too quickly,” said Scripps Health President and CEO Chris Van Gorder. “While our efforts at Scripps have been focused on providing the best care possible to all of our patients throughout this period, we believe the knowledge and experience we have gained in our fight against this disease will help others in the community as they continue to respond to the ever-changing conditions of this health crisis.”

“Our research shows that community restrictions work, and that message couldn’t be any more important than now.”

Scripps Health President and CEO Chris Van Gorder

Beginning on June 12, 2020, county officials approved a series of public health orders that cleared the way for restaurants, bars, wineries, breweries, gyms and some other businesses to restart limited indoor activities under Phase 3 reopening guidelines set by the state of California. On July 7, county officials once again shut down indoor activities at those businesses when the region exceeded per capita coronavirus testing thresholds set by the state during what turned out to be a sharp mid-summer second spike of the disease.

Scripps data experts wanted to know how the temporary reopening affected patient volumes and outcomes at its five hospital campuses. They reached out to scientists in the Department of Environmental Health Sciences at Columbia’s Mailman School of Public Health in New York, who already had used statistical modeling methods to show that early delays in locking down cities and states across the entire country had cost at least 36,000 lives nationwide through the first spike of COVID-19.

Locally, the Scripps and Columbia team focused on two scenarios — not having the 25-day-long phase 3 reopening in the county and shortening the reopening period by one week.

Had county officials left the stricter restrictions in place, 400 COVID-19 hospitalizations and 45 deaths might have been avoided at Scripps’ five hospital campuses, the researchers found. Under the second scenario, 172 hospitalizations and 19 deaths might have been avoided had the temporary reopening been shortened by one week.

Researchers also modeled a third scenario that looked at the potential consequences of leaving the phase 3 reopening conditions in place for a much longer period beyond July 25. Under those circumstances, far more deaths, 85, and hospitalizations, 762, would have occurred.

Findings offer cautionary evidence

The results reinforce the health benefits of social distancing while offering cautionary evidence to public officials who face ongoing pressure to ease restrictions aimed at limiting the spread of the disease, as new and faster-spreading variants of the coronavirus threaten to reverse the progress made in recent weeks to rein in the virus. And more recent modeling at Scripps has demonstrated the effectiveness of San Diego County’s vaccination distribution in curbing COVID-19 transmission, despite the rise of new variants. These results demonstrate the need to continue expanding such efforts, such as those at the public vaccination super station operated by Scripps at the Del Mar Fairgrounds

The research effort used real-world data from Scripps and complex mathematical disease transmission modeling techniques to reveal potential benefits at the region’s largest health system if a higher level of restrictions had been left in place as San Diego County moved into the second peak of the infectious disease locally.

During the time evaluated by the researchers — from the arrival of the virus in the San Diego County community in early March until Aug. 31 — Scripps hospitals recorded 1,268 COVID-19 hospitalizations, 300 ICU admissions and 180 deaths from the virus.

The study utilized an epidemiological concept known as compartmental modeling, which evaluates population movement through disease state phases (susceptible, exposed, infectious, and recovered — or SEIR). SEIR modeling has been used extensively by Scripps and other health care systems during the pandemic to accurately predict future hospitalization trends and volume to prepare for the logistical demands of caring for COVID-19 patients. These predictions were essential to provide hospital executives precious time to prepare for surges in a period when critical resources, such as intensive care unit beds, nurses and supplies of personal protective equipment, were severely constrained.

“We created the summer reopening study to establish additional scientific and evidence-based reassurance that social distancing works,” said Nathaniel Brown, Scripps director of health data sciences. “We would like to reassure the public that their sacrifices — economic, personal and otherwise — are not in vain, but in fact are the key to preventing avoidable sickness and death.”

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