1/n The reason why we knew early about Seattle outbreak of #coronavirus was because of sentinel surveillance work by independent scientists. Such surveillance never got totally underway in other cities. So other U.S. hot spots may not be fully detected yet
The race to unravel the United States’ biggest coronavirus outbreak
Scott Gottlieb, MD on Twitter
2/n The original goal was to implement sentinel surveillance in 5 cities to detect early spread. It was announced in testimony before Senate by HHS. It was expanded to also include Honolulu. Idea was to test indeterminate cases of flu like illness to see if it was #coronavirus.
3/n It was delayed by lack of diagnostic capability to test samples. When it was finally implemented, samples had to be sent to CDC lab which had limited capacity, meaning the surveillance effort was small. It was not expanded beyond original six cities.
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