Kim Carmela Co

#epitwitter #CausalInference
Interests: Environmental Health, Women's Health, Gender-based Violence

[Kim Carmela Co @EpidLife]

After a rapid, but extensive review of literature, we have come up with the following policy recommendations for addressing #COVID19 in the unique health system of the 🇵🇭, lead by @DrKathyReyes
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[Kim Carmela Co @EpidLife]

@carlolorenzo_ 💯💯💯

[Kim Carmela Co @EpidLife]

@megamomph @rocketgirlmd @alikoyyy @DonnaCapiliPH @MAhealthforkids @doktora_ging @RenzoGuinto @genenisperos @jimlopez875 @HPEducatorPH Thank you, doc! Happy to know another Filipina epi :)

[Kim Carmela Co @EpidLife]

@DrKathyReyes @101HealthRsrch @giannagayle @dbayani_ @MelisaMJTan @GDavid_MD @iamyadalei @HinaaaKh @santfro @MianneSilvestre Thank you Doc Kathy. Always grateful to work with you😊

[Kim Carmela Co @EpidLife]

@carlolorenzo_ Wish I was there. Let's take a group photo next time😅

[Kim Carmela Co @EpidLife]

@DrTonyLeachon In an ideal scenario with unlimited tests, we should test as many as possible, including those who are mild/ asymptomatic. They are likely the drivers of community transmission, because they are still interacting, and those positive should be separated from others asap.

[Kim Carmela Co @EpidLife]

#COVID__19 in the Philippines. Travel ban was imposed 33 days after the first reported case. Luzon-wide quarantine was imposed at 43rd day. The effect of this ECQ should be observed around 14 days after, but number of cases is affected by backlogs and increased testing capacity.

[Kim Carmela Co @EpidLife]

@DrTonyLeachon Yes, it looks like some flattening may be happening based on the 7-day rolling averages. However, our testing capacities are just stabilizing so we need to still be on alert for the next few days.

[Kim Carmela Co @EpidLife]

@yourbarriodoc Here's to looking forward to public health systems and health promotion being given much more priority in the future. Keep safe always, doc!

[Kim Carmela Co @EpidLife]

Hey #epitwitter and #healthpolicy,
If you were asked to decide on whether to lift community-wide quarantine/lockdown, which (single) indicator of #COVID19 would you ultimately look at?
Answer is probably all of the above, but just for a thought exercise.

[Kim Carmela Co @EpidLife]

@yourbarriodoc Hay, this pandemic just highlights the gaps. I do hope you get to have a say in what happens in your LGU with regards to ECQ. In epi, we just prepare the data we have in an understandable/impactful way, and hope that policymakers listen. Let me know if I can help in any way

[Kim Carmela Co @EpidLife]

@yourbarriodoc In that case, given the lack of capacity to manage severe cases, the indicator would really have to maximize on those early stages. Agree with focusing on test,isolate,trace,quarantine. Maybe even earlier, like using ILI/symptomatic surveillance?

[Kim Carmela Co @EpidLife]

@ohitsmiko Interesting. All levels of severity, not just ICU?

[Kim Carmela Co @EpidLife]

@DrTonyLeachon Are the doubling time and growth rates also for new cases, doc?

[Kim Carmela Co @EpidLife]

@jrong13 @jimlopez875 Just for discussion, are you looking at population-based mass testing capacity already as an indicator to lift ECQ? (ie testing everyone, even those asymptomatic)

I'm just thinking how much time may be needed to get to this scale @DrKathyReyes

[Kim Carmela Co @EpidLife]

@Miggie707947 This is the most ideal, but it would also mean being in community quarantine for months, which we cannot afford, unfortunately.

[Kim Carmela Co @EpidLife]

@jace_rnMD I guess people see it as an "unwanted" outcome, that should be prevented at all costs. In reality, it might be the most sensitive (and have the most accurate) data. Can definitely understand both sides

[Kim Carmela Co @EpidLife]

@DrKathyReyes @jimlopez875 Definitely agree with both of you. Once ECQ is lifted, strategy should automatically transition to test, isolate, trace, and quarantine, so testing capacity should already be prepared for this.

[Kim Carmela Co @EpidLife]

@mymd8899 DOH is starting to work on using technology for this. We're moving in the right direction, fingers crossed.

[Kim Carmela Co @EpidLife]

@DrTonyLeachon Same as previous reply on denominator of true cases. Further, our definition of "recovered" may have been too strict before (2 negative swabs) and some may not have qualified to be classified as recovered if repeat tests were not done.

Happy easter, doc! Hope you're well.

[Kim Carmela Co @EpidLife]

@DrTonyLeachon 1. True denominator of # of cases is not known without widescale testing yet
2. Overrepresentation of severe/critical cases in the number of "confirmed" cases because of testing strategy up until recently
3. Cases more likely to get tested faster when they are already critical

[Kim Carmela Co @EpidLife]

@Planck_Epoch Can be a lot of things. In that case, would definitely need to look at number of people tested, and characteristics of people tested in terms of age, comorbidities, and severity, at the very least