Dr. Sanjay Kurani was at his daughter’s softball game in March 2020 when he got a call from one of his fellow doctors at Santa Clara Valley Medical Center.
The doctor told him there was a patient at the San Jose, Calif., facility who had an acute respiratory illness, but they hadn’t traveled internationally or knowingly been in close contact with COVID-19 carriers.
Kurani looked at all the people around him, realizing the potential impact of a virus that could easily and discreetly spread through communities.
“That is the moment when your heart sinks. You look at the sea and don’t know how big the tidal wave is that possibly already hit,” said Kurani, who eventually found out that about 11% of Santa Clara Valley’s patients were COVID-positive. “That was the other gut punch.”
Kurani and his coworkers set out to identify who was most vulnerable to COVID-19. They discovered that if patients are male, over the age of 60, have a body-mass index of at least 30 and have comorbidities like diabetes or heart conditions, they are more likely to get sick.
Patients who have fewer than three of those characteristics are extremely unlikely to require hospitalization. And 1 in 8 patients who meet at least three of the criteria will likely get very sick, Santa Clara Valley’s analysis revealed.
The data, disseminated with the help of the local public health department, informed stay-at-home policies that helped curb cases in Northern California.
The risk score still holds up after a year’s worth of data, Kurani said.
“What this taught us is that some of this data analysis is going to have to be done internally,” he said. “As much as we want to rely on the rest of academia and the scientific community, if we are all dealing with a novel pathogen again, it is unfair to ask them to develop analysis quickly because we are all learning at the same time.”
All the disparate sources of information and data were a major obstacle, Kurani said. Santa Clara Valley put together a team to vet the information, centralize it and guide policy decisions.
“There was this vacuum of science-based information,” he said. “Anytime you’d turn on the TV, there was so much information. I would tell people that it is unfair for the American people to try to determine what is signal versus noise.”
The medical center shared what it learned about COVID with area providers as well as county and state agencies, which leaned on each other more than ever before.
They shifted personal protective equipment and testing supplies based on demand. When one hospital was short on beds, another would pick up the slack.
“Even though we take care of the same communities, we’d sometimes operate in silos,” Kurani said. “At the end of the day, our problems became their problems, so we got ahead of it. I can’t stress how important the partnership with other hospitals, county leadership at the public health department as well as the state has been.”