From: Dughig. lg?

To: WE ID macaw
Cc: 
Subject: Re: sentinel surveillance

Date: Sunday, February 2, 2020 7:10:15 PM

Happy to try and help. Does 1p paci?c work?

Jeffrey S. Duchin. MD
Health Of?cer and Chief. Communicable Disease Epidemiology Immunization Section
Public Health - Seattle and King County
Professor in Medicine, Division of Infectious Diseases, University of Washington
Adjunct Professor. School of Public Health
401 5th Ave. Suite 1250. Seattle. WA 98l04
Tel: (206) 296-4774; Direct: (206) 263?8171; Fax: (206) 296-4803
E-mail: jeff.duchin@kingcounty. gov

 

From: Sharon Balter <SBalter@ph.lacounty.gov>

Sent: Sunday, February 2, 2020 7:07:14 PM

To: Pinner, Robert W. Duchin, Jeff
Watt, James (CDC cdph.ca.gov) <James.Watt@cdph.ca.gov>

Cc: Layton, Marci (CDC health.nyc.gov) Lynfield, Ruth (CDC state.mn.us)
<Ruth.Lynfield@state.mn.us>

Subject: Re: sentinel surveillance

 

Email Notice! External communication is important to us. Be cautious of phishing attempts. Do not
click or open suspicious links or attachments.

 

 

 

Yes. and I think it is a good idea!

Get Qutlookjcuil?

From: Pinner, Robert W. <rwp1@cdc.gov>
Sent: Sunday, February 2, 2020 7:06:06 PM
To: Duchin, Jeff (CDC kingcountygov) <jeff.duchin@kingcountygow; Watt, James (CDC cdph.ca.gov)

Sharon Baiter 
Cc: Layton, Marci (CDC health.nyc.gov) Lynfield, Ruth (CDC 5tate.mn.us)

<Ruth .Lynfield @statemn .us>
Subject: sentinel surveillance

 

. External Email. Proceed Responsibly]
Jeff. Sharon, James 

Ruth. Marci and are part of a ?Team group helping the CDC response team think about
issues concerning 2019 nCoV. Considering how urgent it is to get a handle on whether/the
extent to which transmission may be occurring in the US, the group came to the idea of a rapid

sentinel surveillance project in a few key areas. such as yours. There?s more to explain but am
writing today to see if you might be interested? If so, are you potentially available sometime
tomorrow afternoon? Please let me know.

Thanks and regards,
Bob

From: Duchin, Jeff

To: Eng, Alicia Bresee, Joseph Ringer, B?b?li W.

Subject: Re: Sentinel surveillance

Date: Thursday, February 6, 2020 6:37:03 PM

Alicia, Joe, Bob,
I've been inundated sorry not to be more responsive. What is the estimated PPV and NPV
with a pre-test prevalence of 1% and What type of clinical venues are you desiring?

What to do with positive result is a critical issue.

Thanks for doing this!

 

Jeffrey S. Duchin. MD (he/him)
Health Of?cer and Chief. Communicable Disease Epidemiology immunization Section

Public Health - Seattle and King County

Professor in Medicine, Division of Infectious Diseases. University of Washington
Adjunct Professor. School of Public Health

40] 5th Ave. Suite 1250. Seattle. WA 98104

Tel: (206) 296-4774; Direct: (206') 263-8171: Fax: (206) 296-4803

E-mail: jeff.duchin?r?kingeountygov

From: Fry, Alicia <agf1@cdc.gov>

Sent: Thursday, February 6, 2020 3:28 PM

To: Balter, Sharon (CDC ph.lacounty.gov) Layton, Marci (CDC
health.nyc.gov) Weiss, Don (CDC 
Jain, Seema (CDC cdph.ca.gov) Lindquist,
Scott SL (CDC doh,wa.gov) Layden, Jennifer (CDC i linois.gov)
Jessica Sell Prabhu Gounder
Green, Nicole (CDC ph.lacounty.gov) 
Stoltey, Juliet (DPH) Duchin, Jeff <Jeff.Duchin@kingcounty.gov>

Cc: Budd, Alicia Kim, Lindsay 
Hall, Aron Bresee, Joseph
Pinner, Robert W. <rwp1@cdc.g0v>
Subject: Sentinel surveillance

 

Email Notice! External communication is important to us. Be cautious of phishing attempts. Do not
click or open suspicious links or attachments.

Hi,

i wanted to give a quick update on some discussions that we?ve have at CDC around sentinel
surveillance. lam not sure who was in the discussion when Bob Plnner set up these calls. I?ve tried
to include at least one person from each site (Seattle, LA, SF, NYC, Chicago).

 

 

First, there is a limited number of kits and we don?t expect new ones for 3-4 weeks. We got
approval for 1 extra kit for each of the 5 proposed sentinel surveillance site. Each kit can test 700?

 

800 specimens (this accounts for the controls that are needed). So, this is going to be our rate
limiting step.

Second, we discussed the use of the kit for surveillance. We were assured that the EUA package
allows the use of the assay for surveillance as long as FDA is notified and approves. Julie Villanueva
said FDA expects these types of requests. There would be some things to work out, like the protocol
if a test is positive. The clinician cannot get the surveillance result back, but I think we could come
up with a method that worked for all.

Finally, Alicia Budd (from ID) is working on a short description of this (sort of a SOP) that gives you
latitude to find specimens the best way for you but allows us to submit something to Human
Subjects to get a public health response determination and to submit to FDA. It would be good if we
all had a call so she can get your feedback on a few things and maybe we can work out the protocol
for a results. From flu right sizing, here is a table that shows what prevalence you could detect
with different numbers of specimens. For the next month, we will need to balance the frequency of
testing, the number tested with the limited of tests. After there are more kits, we can revisit the
number tested.

 

Approx. it of nCoV kits needed
(assumes each kit can test 700-
800 specimens using a full

of specimens needed
Confidence level to test to identify 1
nCoV positive

Prevalence of
nCoV to detect

 

 

plate).
0.50% 95% 598 1 kit
1.00% 95% 299 .5 kit

 

 

 

 

 

 

Alicia Budd is going to lead this activity for us. Look for communication re: a call.

Alicia

Alicia Fry, MD, MPH

CAPT USPHS

Currently detailed to Novel response
Epi Task Force lead

afry@cdc.gov

From: 
T0: Manes: damn-2; Ilm 'Karasa?la?
Subject: RE: Statement about nCoV surveillance
Date: Friday, February 14, 2020 11:28:00 AM

- 2? 7 

Final draft statement (removed UW mention):

At this time, neither Public Health Seattle King County or WA State Department of Health are
participating in any new surveillance or special testing project for We recognize the
importance of learning more about the potential distribution of this new disease in the
population as the outbreak progresses and we have informed CDC that we are willing to consider
collaborating on surveillance work in the future, although there are no plans to do so at this time.

 

Jeffrey S. Duchin, MD

Health Officer and Chief, Communicable Disease Epidemiology immunization Section
Public Health - Seattle and King County

Professor in Medicine, Division of Infectious Diseases, University of Washington
Adjunct Professor, School of Public Health

401 5th Ave, Suite 1250, Seattle, WA 98104

Tel: (206) 296-4774; Direct: (206) 263-8171; Fax: (206) 296?4803

E-mail: jeff.duchin@kingcountygov

From: Duchin, Jeff

Sent: Friday, February 14, 2020 11:25 AM

To: Apa, James Hayes, Patty 
Elsenboss, Carina Li-Vollmer, Meredith <Meredith.Li?
Karasz, Hilary <HiIary.Karasz@kingcounty.gov>

Subject: RE: Statement about nCoV surveillance

DOH has minor edit: At this time, neither Public Health - Seattle King County, WA State
Department of Health or the University of Washington are participating in any new surveillance
or special testing project for COVID-19. All three agencies recognize the importance of learning
more about the potential distribution of this new disease in the population as the outbreak
progresses and we have informed CDC that we are willing to consider collaborating on
surveillance wok in the future, although there are no plans to do so at this time.

 

Jeffrey S. Duchin, MD
Health Officer and Chief, Communicable Disease Epidemiology Immunization Section

Public Health - Seattle and King County

Professor in Medicine, Division of Infectious Diseases, University of Washington
Adjunct Professor, School of Public Health

401 5th Ave, Suite 1250, Seattle, WA 98104

Tel: (206) 296-4774; Direct: (206) 263-8171; Fax: (206) 296?4803

Email: ieffguchin@kinggounty,gov

From:Apa, Iames <Jam mes. Apa@ki ki wgcounty gov>
Sent: Friday, February 14,2020 11: 18 AM

To: Hayes Patty DggQiin ty ng Elsenboss, Carina

Li- Vollmer, Meredith <Mereglith,ii- 
Karasz,HiIary< .K kin 
Cc: Duchin,Jeff< ff. h' i . v>

Subject: FW: Statement about nCoV surveillance

FYI ?Jeff?s working on a statement; I?m reaching out to my media contact at Seattle Flu Study; DOH
comms working on it as well.

From: Duchin, Jeff 

Sent: Friday, February 14, 2020 10:59 AM

To: Lindquist, Scott (DOH) Mark] Rieder 
Cc: Helen Chu I 

Subject: Statement about nCoV surveillance

Draft statement in response to unanticipated announcement that ?Seattle? is participating
in a CDC sentinel surveillance project for COVID19.

At this time, neither Public Health Seattle 8: King County, WA Department of Health or the
University of Washington are participating in any new surveillance or special testing project for
COVID-19. All three agencies recognize the importance of learning more about the potential
distribution of this new disease in the population as the outbreak progresses and we have
informed CDC that we are willing to consider collaborating on surveillance wok in the future,
although there are no plans to do so at this time.

Let me know if you have edits ASAP.
Thanks for helping us sort this out.

Jeff

 

Jeffrey S. Duchin, MD

Health Officer and Chief, Communicable Disease Epidemiology Immunization Section
Public Health - Seattle and King County

Professor in Medicine, Division of Infectious Diseases, University of Washington
Adjunct Professor, School of Public Health

401 5th Ave, Suite 1250, Seattle, WA 98104

Tel: (206) 296-4774; Direct: (206) 263-8171,- Fax: (206) 296?4803

E-mail: 

From: hin

To: 
Cc: H.WA.
Subject: RE: Help!

Date: Friday, February 14, 2020 11:29:00 AM

This is finals: At this time, neither Public Health - Seattle King County or WA State Department
of Health are participating in any new surveillance or special testing project for We
recognize the importance of learning more about the potential distribution of this new disease in
the population as the outbreak progresses and we have informed CDC that we are willing to
consider collaborating on surveillance work in the future, although there are no plans to do so at
this time.

 

Jeffrey S. Duchin, MD

Health Officer and Chief, Communicable Disease Epidemiology Immunization Section
Public Health - Seattle and King County

Professor in Medicine, Division of Infectious Diseases, University of Washington
Adjunct Professor, School of Public Health

401 5th Ave, Suite 1250, Seattle, WA 98104

Tel: (206) 296-4774; Direct: (206) 263-8171; Fax: (206) 2964803

E?mail: jeff.duchin@kingcounty.gov

From: Duchin, Jeff

Sent: Friday, February 14, 2020 11:01 AM

To: Lindquist, Scott (DOH) <scott.lindquist@doh.wa.gov>

Cc: Kathy Lofy (Kathy. Lofy@ DOH.WA.GOV) <kathy.lofy@doh.wa.gov>
Subject: RE: Help!

FWIW, I just got a message from NYC saying they though Scott was planning to do this surveillance
through sentinel system. So, Scott, although you expressed to me you have made no plans, multiple
others are hearing it differently maybe miscommunication happening with multiple groups.

 

Jeffrey S. Duchin, MD
Health Officer and Chief, Communicable Disease Epidemiology Immunization Section

Public Health - Seattle and King County
Professor in Medicine, Division of Infectious Diseases, University of Washington

Adjunct Professor, School of Public Health
401 5th Ave, Suite 1250, Seattle, WA 98104
Tel: (206) 296-4774; Direct: (206) 263-8171; Fax: (206) 296-4803

E-mail: ieffduch in kingcoimtygov

From: Duchin, Jeff
Sent: Friday, February 14, 2020 10:18 AM

To: Lindquist, Scott (DOH) 

Cc: Kathy Lofy (Kathyj 
Subject: RE: Help!

Either big time miscommunication going on or UW working directly with CDC. I?m sorting this out
and will keep you posted. Just off the phone with Gates Ventures and connected with Dann Jernigan
and Joe Breese at CDC to help figure out what?s happenitg!

 

Jeffrey S. Duchin, MD

Health Officer and Chief, Communicable Disease Epidemiology Immunization Section
Public Health Seattle and King County

Professor in Medicine, Division of Infectious Diseases, University of Washington
Adjunct Professor, School of Public Health

401 5th Ave, Suite 1250, Seattle, WA 98104

Tel: (205) 296-4774,- Direct: (206) 263-8171,- Fax: (206) 296?4803

E-mail: 

From: Duchin, Jeff
Sent: Friday, February 14, 2020 9:59 AM

To: Lindquist, Scott (DOH) 

Subject: FW: Help!

FYI

 

Jeffrey S. Duchin, MD

Health Officer and Chief, Communicable Disease Epidemiology Immunization Section
Public Health Seattle and King County

Professor in Medicine, Division of Infectious Diseases, University of Washington
Adjunct Professor, School of Public Health

401 5th Ave, Suite 1250, Seattle, WA 98104

Tel: [206) 296?4774; Direct: (206) 263?8171,- Fax: (206) 296-4803

Email: WW

From: Bresee, Joseph 
Sent: Friday, February 14, 2020 9:55 AM

To: Duchin, Jeff left, Duchin lgingcgu nty.gov>
Subject: RE: Help!

 

Email Notice! External communication is important to us. Be cautious of phishing attempts. Do not
click or open suspicious links or attachments.

Alicia Budd in Alicia?s Fry?s group organizing this small group (5 sites). They had a call yesterday and
tell me that Helen Chu and Trevor Bedford joined (WW). Not sure how they were
engaged initially, and assume that they assumed you were engaged as well. Can run this down and

connect you with them, but you might know them?

 

 

 

As an extra fact from Alicia, they will plan to use the UW assay developed for the Seattle Flu study,
so not sure how it will fit into public health response. That is, what happens when you get a positive
with a non-EUA test? Your group will need to be involved, obviously, and if your note will work to
changethat

Sorry to not appreciate that you weren?t in the loop.
joe

From: Duchin, Jeff <Jeff.Duchin@kinecountv.g0v>

Sent: Friday, February 14, 2020 12:43 PM

To: Bresee, Joseph 
Subject: Help!

Nancyjust announced on a national media call that CDC is doing sentinel surveillance in Seattle I
know nothing about this - can you please fill me in 

 

Jeffrey S. Duchin, MD

Health Officer and Chief, Communicable Disease Epidemiology Immunization Section
Public Health - Seattle and King County

Professor in Medicine, Division of Infectious Diseases, University of Washington
Adjunct Professor, School of Public Health

401 5th Ave, Suite 1250, Seattle, WA 98104

Tel: (206) 296-4774; Direct: (206) 263?8171; Fax: (206) 296-4803

E-mail: ieffdughin@kingcounty.goy

From: MW

To: mm
Subject: Re: nCoV Surveillance

Date: Saturday, February 15, 2020 10:02:24 PM

-- . . 

Thanks, I did not realize you could not share results with public health. Would be good to
know timeline for commercial test. Perhaps aggregate results (or by test site) might be
something to consider. Are they all outpatient/mild illness? Is there any way for you to see
what the clinical course was? I'll try you tomorrow.

Jeff

 

Jeffrey S. Duchin, MD (hei?him)

Health Of?cer and Chief. Communicable Disease Epidemiology immunization Section
Public Health - Seattle and King County

Professor in Medicine. Division of infectious Diseases. University of Washington
Adjunct Professor, School of Public Health

401 5th Ave. Suite 1250. Seattle. WA 98104

Tel: (206) 296-4774; Direct: (206) 263?8171; Fax: (206) 296-4803

E-mail: 

From: Helen Chu <helenchu@uw.edu>

Sent: Saturday, February 15, 2020 9:26 PM

To: Duchin, Jeff <Jeff.Duchin@kingcounty.gov>
Subject: Re: nCoV Surveillance

 

Email Noticel External communication is important to us. Be cautious of phishing attempts. Do not
click or open suspicious links or attachments.

Hi Jeff,

All the samples we have collected can be tested for for research use. Our samples come from
the hospitals (UWMC, Harborview, Northwest, Seattle Childrens), as well as the Kaiser outpatient
clinics and King County sentinel surveillance samples. We also have samples we collected from our
community sites, including the airport, schools, families with young children, and all of the kiosks
throughout the city. We have samples starting October 1, 2019 until now. The total count is about

30,000 to 40,000.

 

 

 

We are not authorized to return any results from our testing unless it is performed using a CLIA-
waived instrument for now, this is a Cepheid or an Abbott. This includes return of result to
participants, as well as return of results to Dept of Health.

Some possibilities:
1. We provide aggregate overall results about positivity (no identifiable info, no linkers) for

population level data
2. We wait until Cepheid has a CLIA-exempt test l?m not sure where this is in
development, but can reach out to them. We are actively collaborating with them.

Happy to talk on the phone. Tomorrow anytime or Monday morning would work for me. My cell is
617 935 9509.
Helen

Helen Y. Chu, MD MPH
Division of Allergy Infectious Diseases

chulaborg
*Our lab has moved to a new location in South Lake Union?

From: Jeff Duchin <Jeff.Duchin@kingcounty.gov>
Date: Saturday, February 15, 2020 at 8:28 PM
To: Helen Chu 

Subject: nCoV Surveillance

Helen, we had a pretty clear answer today from CDC that the unapproved test can not be
used to inform patients, physicians OR as an entry into a pathway for testing with an approved
test. l'm trying to figure out what, if anything, we can do. Remind me what type of
sample/sources you have and corresponding permission to do nCoV testing. Going forward,
there should be a way to incorporate SFS if we end up doing any prospective sentinel
surveillance with CDC (perhaps simultaneous testing of flu-negative specimens). If you;re
around tomorrow or Monday maybe we can chat briefly.

Jeff

 

Jeffrey S. Duehin. MD (he/him)

Health Of?cer and Chief. Communicable Disease Epidemiology Immunization Section
Public Health - Seattle and King County

Professor in Medicine. Division of infectious Diseases. University of Washington
Adjunct Professor. School of Public Health

401 5th Ave. Suite 1250. Seattle. WA 98104

Tel: (206) 296?4774: Direct: (206) 263-817]; Fax: (206) 296-4803

E-mail: 

From: WEED.)

TO: W: 
Subject: RE: FWIW

Date: Saturday, February 15, 2020 2:05:50 PM

 

Email Notice! External communication is important to us. Be cautious of phishing attempts. Do not
click or open suspicious links or attachments.

 

 

Yes, I think so at least we should plan for that.

From: Duchin, Jeff <Jeff.Duchin@kingcounty.gov>

Sent: Saturday, February 15, 2020 4:50 PM

To: Bresee, Joseph Jernigan, Daniel B. 
<dbj0@cdc.gov>

Subject: Re: FWIW

PS - I know you've got your team weighing in on this and I really appreciate you getting
feedback from folks on front line re: operational details. Would there be a CDC team available
to assist with of positives and contacts? l'm worried
about people not having a place for communiyt~based isolation/quarantine (eg high risk peron
in home, home doesnlt meet criteria for housing famliy/landlord freaks out, etc).

 

Jeffrey S. Duchin. MD (hei?him)

Health Of?cer and Chief. Communicable Disease Epidemiology 8; Immunization Section
Public Health - Seattle and King County

Professor in Medicine. Division of Infectious Diseases. University of Washington
Adjunct Professor. School of Public Health

401 5th Ave. Suite 1250. Seattle, WA 98104

Tel: (206) 296-4774: Direct: (206) 263-8171: Fax: (206) 296-4803

E-mail: 'i 

   

From: Duchin, Jeff 
Sent: Saturday, February 15, 2020 1:43 PM
To: Bresee, Joseph ?gmegoyz Jernigan, Daniel B. 


Subject: Re: FWIW

Thanks, Joe. One issue with these cases is that they will not have been under quarantine and
likely have many community and HCW exposures, and a relatively high proportion of
contacts by the time we identify them.

Jeff

 

Jeffrey S. Duchin. MD (hefhim)

 

Health Of?cer and Chief. Communicable Disease Epidemiology Immunization Section
Public Health - Seattle and King County

Professor in Medicine, Division of Infectious Diseases. University of Washington
Adjunct Professor. School of Public Health

40] 5th Ave. Suite 1250, Seattle. WA 98104

Tel: (206) 296-4774: Direct: (206) 263-817]: Fax: (206) 296-4803

E-mailr MW

From: Bresee, Joseph 

Sent: Saturday, February 15, 2020 1:31 PM

To: Duchin, Jeff Jernigan, Daniel B. 
demos?

Subject: RE: FWIW

 

Email Notice! 1 External communication is important to us. Be cautious of phishing attempts. Do not
click or open suspicious links or attachments.

Thanks for clarification. Yes, you are correct re the UW test.

 

 

Talked with Gayle after the call she will draft a short protocol and share with the group. Will
suggest that the draft have a proposal for what to do with a positive that aligns with the current
containment activities, including contact tracing etc, - for group discussion.

I will take a crack a concept note re what to do with a positive in the community in terms of triggers
to modify containment posture, either locally or nationally again fro group input. For this, will
propose a discussion with the small group of members for rapid input, so that we can
get a consensus before the first patient is swabbed. Try to set up such a call Mon or Tues.

Thanks for thinking through all of this with us.
Joe

From: Duchin, Jeff <Jeff.Duchin@kingcountv.eov>
Sent: Saturday, February 15, 2020 4:26 PM
To: Bresee, Joseph Jernigan, Daniel B. 

<de?l@cdceox>
Subject: Re: FWIW

N0 I understood that the EUA does not permit use ofthe UW virology in house assay.

Would love to participate in the sentinel surveillance if we can work out the response
actions/logistics. Lot?s of details on the ground and resource implications for PH, 

and patient.

Jeff

 

From: 

To: Timothy H. mllit; ,1th 
Subject: Sentinel Surveillance?

Date: Saturday, February 15, 2020 1:12:04 PM

We are discussing with CDC possibility of sentinel surveillance for in patients with
unexplained resp illness in general and no known risk factors for exposure (outpatient
primarily but hospitalized also fine). Would clinics potentially be interested in
providing swabs on cases that consent to this extra testing prospectively and that are neg for
other pathogens? Lots of implications to think through should we get a positive for
patient/their contacts/HCW. Point is to know when unrecognized community transmission is
occurring that would lead to shift in response strategy.

Jeff

 

Jeffrey S. Duchin, MI) (he/him)

Health Of?cer and Chief. Communicable Disease Epidemiology Immunization Section
Public Health - Seattle and King County

Professor in Medicine. Division of Infectious Diseases. University of Washington
Adjunct Professor. School of Public Health

40] 5th Ave. Suite 1250. Seattle. WA 98104

Tel: {206) 296-4774: Direct: (206') 263-8171: Fax: (206) 296-4803

E-mail: 

 

Jeffrey S. Duchin. MD (he/him)

Health Of?cer and Chief, Communicable Disease Epidemiology immunization Section
Public Health - Seattle and King County

Professor in Medicine. Division of Infectious Diseases. University of Washington
Adjunct Professor. School of Public Health

401 5th Ate. Suite 1250. Seattle. WA 98104

?lei: {206) 296- 4774 Direct: (206) 263- 8171: Fax: (206) 296- 4803

-mail:

 

From: Bresee, Joseph 

Sent: Saturday, February 15, 2020 1:20 PM

To: Duchin, Jeff Jernigan, Daniel B. 
<dhi?@cdceox>

Subject: RE: FWIW

 

Email Notice! 1 External communication is important to us. Be cautious of phishing attempts. Do not
click or open suspicious iinks or attachments.

No for participating in the prospective surveillance project?

 

 

From: Duchin, Jeff ff. 'n 

Sent: Saturday, February 15, 2020 3:00 PM

To: Jemigan, Daniel B. Bresee, Joseph 


Subject: FWIW

I hear the answer is no.

 

Jeffrey S. Duchin. MD (he/him)

Health Of?cer and Chief. Communicable Disease Epidemiology Immunization Section
Public Health - Seattle and King County

Professor in Medicine. Division of Infectious Diseases. University of Washington
Adjunct Professor. School of Public Health

401 5th Axe. Suite 1250. Seattle. WA 98104

Tel: (206) 296? 4774: Direct: (206) 263- 8171; Fax: (206) 296- 4803

E- mail: 

 

@0911?

Isaac Green Nicole (CDC ph lacounty. gov) 
Hector Rivas Jain, Seema (CDC 
Jessica Sell Justin DeWitt Kauerauf, Judy (CDC
illinoisgov) Kuhnert-Tallman, Wendi 
<utdkl?dcgop; Layden, Jennifer (CDC illinois. gov) <iQQniferJayden @illI iQQi5,ng>; Layton, Marci
(CDC health. nyc. gov) <mlathQ@heaith,nyc,ng Lindquist, Scott SL (CDC doh. wa. gov)

.lin Meredith Haddix <Mijaddi x.@Qh lagQiin n;ty,ng> Molly Lamb
nty,ng>,- Rakeman,
JenniferJR (CDC health. gov) Rose, Laura E.
Sarah Park <Wumgm>; Thomas?
Smith Evonda i th ng>; Vagi, SaraJ. 

<h Weiss, Don (CDC health.nyc.gov) <dyygi 55@ Zahn, Matthew


Cc: Balter, Sharon (CDC ph.lacounty.gov) 

Subject: RE: sentinel surveillance updates

 

Email Notice! External communication is important to us. Be cautious of phishing attempts. Do not
click or open suspicious links or attachments.

 

 

 

Hello. I have enclosed an updated guidance document that includes information on shipping
specimens and an example of an information sheet that you can provide to patients. The guidance
document only lists the details of what is planned at 2 sites, but that does not preclude others from
starting. They were just used as examples for the EUA submission. A shipping log is also attached.
We are ready to start receiving specimens whenever you are ready to send them. We cannot start
testing the identified specimens until the EUA is amended, but we believe that will happen quickly.
For those that want to send de-identified specimens, we can receive and test them now.

Our questions to you:
1. Are you planning to send die-identified specimens and when?
2. Are you planning to send identifiable specimens and when?

On the call tomorrow, we will talk about options for data transfer. There will also likely be time to
talk about triggers for changing current containment strategies.

Talk to you tomorrow. ?-gayle

Original 

From: Langley, Gayle E. 

Sent: Wednesday, February 19, 2020 5:22 PM

To: Langley, Gayle E. Balter, Sharon (CDC health.nyc.gov); Bresee, Joseph
Christine Mahle; Conover, Craig (CDC illinois.gov); Duchin, Jeff (CDC
kingcountygov); Ghinai, Isaac; Green, Nicole (CDC Hector Rivas; Jain, Seema (CDC
cdph.ca.gov); Jessica Sell; Justin DeWitt; Kauerauf, Judy (CDC illinoisgov); Kuhnert-Tallman, Wendi
Layden, Jennifer (CDC Layton, Marci (CDC health.nyc.gov); Lindquist,
Scott SL (CDC doh.wa.gov); Meredith Haddix; Molly Lamb; E?QunderQQh.lacounty.gov; Rakeman,
Jennifer JR (CDC health.nyc.gov); Rose, Laura E. Sarah Park; Thomas-

From: 

T0: deJeaLCitu

Cc: Mark; Bigger; Paul N?in; Cowgill. Karen
Subject: Re: SFS and Sentinel Surveillance

Date: Friday, February 21, 2020 10:42:l'm optimistic CDC is going to allow nasal swabs for surveillance, so the sooner we can hash
out the details of potential SFS participation the better, pending your review of the draft
protocol.

 

Jeffrey S. Duchin. MD (he/him)

Health Officer and Chief. Communicable Disease Epidemiology immunization Section
Public Health - Seattle and King County

Professor in Medicine. Division of Infectious Diseases. University of Washington
Adjunct Professor. School of Public Health

401 5th Ave. Suite 1250. Seattle. WA 98104

Tel: (206) 296-4774: Direct: (206) 263-8 71: Fax: (206) 296-4803

Email: jeff.duchin@kingcounly.gov

From: Duchin, Jeff

Sent: Friday, February 21, 2020 10:11 AM

To: Helen Chu 

Cc: Markl Rieder Paul Nevin <paul.nevin@gatesventures.com>

Subject: SFS and Sentinel Surveillance

l'm still pushing on CDC to accept the nasal swab samples. Please see the attached draft
surveillance protocol - would need to be able to conform to this if we are able to go forward.
Does this work for you? Please do not share outside of those who need to see at this point.

Jeff

 

Jeffrey S. Duchin, MD (he/him)

Health Of?cer and Chief. Communicable Disease Epidemiology Immunization Section
Public Health Seattle and King County

Professor in Medicine. Division of Infectious Diseases. University of Washington
Adjunct Professor. School of Public Health

401 5th Ave, Suite 1250, Seattle, WA 98104

Tel: (206) 296-4774: Direct: (206) 263-8171; Fax: (206) 296-4803

E-mail: _ieff.duchianingcountygov

Smith, Evonda; Vagi, Sara J. Weiss, Don (CDC health.nyc.gov); Zahn,
Matthew

Cc: Balter, Sharon (CDC phlacountygov)

Subject: sentinel surveillance updates

When: Friday, February 21, 2020 1:00 PM Eastern Time (US 8: Canada).
Where: Skype Meeting

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From: WW

To: 
illi 
DEM-25M: Wm mm 
WW lessica??; Wow GhinaL
15.63? miles: MILE Kutmtt
Wlm- DD 
B, 

Cc: PH I 

Subject: RE: updates on sentinel surveillance activity-mow with attachment

Date: Thursday, February 20, 2020 4:37:50 AM

Attachments: i - i

 

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click or open suspicious links or attachments.

 

 

Friends,

Please see the 1.5 pager attached, intended to elicit your advice on triggers, and actions. I put
questions at the end, but feel free to comments on anything. Since you all will be possibly be the
earliest jurisdictions to identify community cases, your input if critical. In parallel, these issues are
being discussed in the use in the next day or two, so your input will be important to inform this

process.

Again, thanks for the interest in getting surveillance stood up quickly. Hoping that some of you can
start collecting and sending in the next days (or de-identifying and sending in the next day or two).

JOE

Joseph Bresee, MD
Deputy incident Manager
CDC 2020 nCoV response

From: Bresee, Joseph <jsb6@cdc.goy>

Sent: Wednesday, February 19, 2020 8:57 PM

To: Langley, Gayle E. Layton, Marci (CDC health.nyc.gov)
Layden, Jennifer (CDC illinoisgov) 
Lindquist, Scott SL (CDC doh.wa.gov) Jain, Seema (CDC cdph.ca.gov)
Weiss, Don (CDC health.nyc.gov) Balter,
Sharon (CDC ph. acounty.goy) PGounder@ph.Iacountygov; Meredith
Haddix Rakeman, Jennifer JR (CDC health.nyc.gov)
Christine Mahle Kauerauf, Judy (CDC
iliinoisgov) Green, Nicole (CDC ph.lacounty.gov)
Patheia, Preeti (CDC health.nyc.gov) 
Jessica Sell Conover, Craig (CDC illinoisgov) 
Ghinai, isaac Hector Rivas Zahn, Matthew

 

 DeWitt, Justin Thomas-Smith, Evonda
Lamb, Molly Duchin, Jeff (CDC
kingcountygov) Kuhnert-Tallman, Wendi 
Park, Sarah Y., MD Rose, Laura E.
Jernigan, Daniel B. 
<dbj0@cdc.gov>

Cc: Vagi, Sara J. Bresee, Joseph 
<jsb6@cdc.gov>

Subject: RE: updates on sentinel surveillance activitynnow with attachment

All,

Thanks for the discussion today on possible triggers for changing the response posture. lnstead of a
call to discuss this, as I had initially offered, maybe the more efficient way to start the discussion is to
comment on a short one?page draft approach- as I know that you have plenty of meetings to attend
already. I will share something tomorrow AM for comment and we can follow up with a call, if that
seems 

Thanks again for the discussion today. Will get you something to comment on shortly. Thanks
Joe

Joseph Bresee, MD
influenza Division
Centers for Disease Control and Prevention

Original Appointment?w?

From: Langley,Gayle E. <f 27 cd . 

Sent: Tuesday, February 18, 2020 5:31 PM

To: Langley, Gayle E. Layton, Marci (CDC health.nyc.gov); Layden, Jennifer
(CDC illinois.gov); Lindquist, Scott SL (CDC doh.wa.gov); Jain, Seema (CDC cdph.ca.gov); Weiss, Don
(CDC health.nyc.goy); Balter, Sharon (CDC ph.lacounty.gov); Meredith
Haddix; Rakeman, Jennifer JR (CDC health.nyc.g0v); Christine Mable; Kauerauf, Judy (CDC
illinoisgov); Green, Nicole (CDC Pathela, Preeti (CDC Jessica Sell;
Conover, Craig (CDC illinoisgov); Ghinai, lsaac; Hector Rivas; Zahn, Matthew; DeWitt, Justin;
Thomas-Smith, Evonda; Lamb, Molly; Duchin, Jeff (CDC kingcountygov); Bresee, Joseph
Kuhnert-Tallman, Wendi Park, Sarah Y., Rose, Laura E.
Jernigan, Daniel B. 

Cc: Vagi, Sara J. 

Subject: updates on sentinel surveillance activity-mow with attachment

When: Wednesday, February 19, 2020 1:00 PM Eastern Time (US Canada).

Where: Skype Meeting

Adding the updated draft protocol. --gayle

I am very sorry to have to do this, but the 3pm ET slot conflicts with an APHL call and there is a CSTE
call at 4pm ET. I hope this works for most. If you could have at least one attend person on per site,
that would be great.

Agenda: Updates on possible approaches to surveillance (which may vary by site) and how EUA
considerations, testing capacity at sites/CDC, human subjects and communication of a positive result
factors in to deciding the best approach at each site

Trouble Joining? Irv Web App

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Conference ID: 77861272
you: dial?in Help

 PRE-DECISIONAL

Transitioning from Border Control to Home Containment to Community Mitigation
Concept of Operations for USG nCoV Response Effort
CDC - February 20

Planning for Global Spread Using Pandemic In?uenza Plans for nCoV Response

- The early understanding of nCoV shows a global Spread that aligns more with pandemic influenza characteristics
than MERS or SARS prompting use of pandemic influenza plans for preparedness and response

- The 2018 FEMA Pandemic Crisis Action Plan uses a set of CDC ?intervals? in its concept of operations with
defined triggers and actions 

Control and containment strategies have a utility at an early window of time

- Once triggers indicating widespread human-to-human spread in the U.S. or in multiple countries is recognized, a
phased transition to a mitigation strategy is indicated

    
  

 

 

 

Current
Hubei

Province

3 Current

3 Current U.S. Situation Overall

.

- Chlna

g, Window for Early

15.5 Containment efforts

958

I.

.

intervals Investigation 9

 

 

Current Posture Federal Quarantine Efforts for Border Control
- USG is currently using a control strategy for addressing nCoV emergence with a goal to slow the introduction
and eventual spread of nCoV in the U.S. (aligns with late ?Recognition? and early ?initiation? intervals in the U.S.)
These efforts are designed to buy time for advancing U.S. preparedness.
- These activities include a focus on identifying persons with possible infection at the border.
0 Digger for Current Posture: Confirmation of nCoV infection in China with demonstrated efficient and
sustained human?to-human transmission. Trigger achieved in mid-January with Wuhan reports.
0 Action: Current border measures include:
I All travelers exposed to China in the last 14 days receive a health assessment at the ifthey have
(fever, cough, SOB) are referred for medical evaluation.
I If travelers have no and:
0 Were in Hubei in the last 14 days, they are subject to mandatory 14-day quarantine near
the port of entry
0 Were in China (non-Hubei) in the last 14 days, allowed to reach their final destinations
and required to stay home and restrict movement for 14 days

 PRE-DECISIONAL

Transitioning from Containment to Community Mitigation Efforts
- As the number of nCoV cases increases in the U.S., public health measures will be adjusted to accommodate for

the changing epidemiology and risk as described in the 2018 FEMA Pandemic Crisis Action Plan and supporting
documents. (aligns with ?Acceleration? interval in the US.)

- A phased transition from the current containment approach public health managed case- and contact-

of interventions that are intended to minimize the impact of illness and death, like efforts for seasonal or

pandemic influenza) is recommended when there isievidence of ongoing human-to-hu man transmission immof
nCoV in the U.S.:

Triggers:

. Greater than 3 generations of human-to-human nCoV transmission, concurrent in multiple
noncontiguous U.S. locations
Detection of nCoV infections in persons in the US. with no epidemiologic link to travel or other
infected persons, concurrent in multiple noncontiguous US locations
Evidence that public health systems in multiple noncontiguous US locations are unable to meet
the demands for achieving containment efforts

. Evidence that healthcare systems in multiple noncontiguous US locations are unable to meet the
demands for providing care
0 3M: Phase out individualized quarantine, home containment, and resource-intensive measures and
implement broader community? and healthcare-based mitigation measures proportionate to disease
severity and impact on healthcare systems. 
- Consideration can be given to regional triggers and decisions, depending on the epidemiology, severity and
public health resources.

Questions for the group:
1. Do current triggers above make sense conceptually? .
2. In the second bullet, how many infections with no epi link are needed to transition away from containment?

Is this a decision for the local jurisdiction state) or nationally?

In the last two, assume that local jurisdictions can assess these? - 1. .

4. Might there be a phased transition rather than turn off all containment ?-as triggers are Tet. Eg. [lust 
examples) ?rst epi-unlinked cases might result in 1) maintaining case Isolation at home; 2) . decrease:I con ac
tracing; 3) implement enhanced surveillance to understand the scope - maybe Increase testing ,rzv;tter
appropriate PPE, in larger group of clinics in representative way? Or test banked specimens in 

5. 2:213:55ij (:ctiZZItify communications folks in your groups to work with our comms folks on early messaging if a

case is identified?

5?

From: 

To: Wm Elsenbese?at?a
Subject: Update on Sentinel Surveillance

Date: Friday, February 21, 2020 9:01: 14 AM

Still participating in CDC small work group on this (conf call later today). Our initial plan seems
to have has fallen through as the FDA won;t allow CDC to accept specimens collected by the
Seattle Flu Study (for now). I?ve reached out to a few community?based HC systems to see if
there is interest in doing this (KP, HMC, ICHS). if so, will begin work to get it up and running.
Nothing likely to happen before 7?10 days at the earliest. Will keep you posted.

 

Jeffrey S. Duchin. MI) (he/him}

Health Of?cer and Chief. Communicable Disease Epidemiology Immunization Section
Public Health - Seattle and King County

Professor in Medicine. Division ot?lnl?ectious Diseases. University of Washington
Adjunct Professor. School of Public Health

40] 5th Ave, Suite 1250. Seattle. WA 98104

Tel: (206') 296?4774: Direct: (206) 263-8171: Fax: (206) 296-4803

E-mail: 

From: WW2)

To: Wise/.1121; 
Subject: RE: sentinel surveillance updates

Date: Saturday, February 22, 2020 11:06:Email Notice! External communication is important to us. Be cautious of phishing attempts. Do not
click or open suspicious links or attachments.

 

 

Sure. I can put something together. --gayle

From: Bresee, Joseph <jsb6@cdc.gov>

Sent: Saturday, February 22, 2020 2:03 PM

To: Duchin, Jeff (CDC kingcountygov) Langley, Gayle E.
<fez7@cdc.gov>

Subject: RE: sentinel surveillance updates

Yep, agree. Gayle I think that we might remind all collaborators that if they cant stand up their
prospective surveillance sites until late next week, they may send already collected deidentified
samples sooner as long as you all have worked through the labelling, shipping issues.

From: Duchin, Jeff [ef?uughm ng>

Sent: Saturday, February 22, 2020 2:01 PM
To: Bresee, Joseph Langley, Gayle E.


Subject: Re: sentinel surveillance updates

it would be very important that this be viewed as a legit and important alternative to identifed

 

Jeffrey S. Duchin. MD (he/him)

Health Of?cer and Chief. Communicable Disease Epidemiology Immunization Section
Public Health - Seattle and King County

Professor in Medicine. Division of Infectious Diseases. [.lniversity of Washington
Adjunct Professor. School of Public Health

401 5th Ave. Suite 1250. Seattle. WA 98104

Tel: (206) 296-4774; Direct: (206) 263-8171: ax: (206) 296-4803

E-mail: inrc?i'kin

From: Bresee, Joseph 
Sent: Saturday, February 22, 2020 10:59 AM

To: Duchin, Langley, Gayle E. 
<?ezl?degov>

Subject: RE: sentinel surveillance updates

 

I Email Notice! External communication is important to us. Be cautious of phishing attempts. Do not

 

[click or open suspicious links or attachments.
I heard yesterday that at least you, Hi and NYC were going that way. Not sure about the others.

Gayle?

From: Duchin, Jeff ff hi v>

Sent: Saturday, February 22, 2020 1:58 PM

To: Bresee, Joseph Langley, Gayle E.
<f?zz@gdg ng>

Subject: Re: sentinel surveillance updates

Aren't other sites also doing deidentified? I thoguth NYC, CA and 

 

Jeffrey S. Duchin. MD (he/him)

Health Of?cer and Chief. Communicable Disease Epidemiology Immunization Section
Public Health - Seattle and King County

Professor in Medicine. Division of Infectious Diseases. University of Washington
Adjunct Professor. School of Public Health

40] 5th Ave. Suite 1250. Seattle. WA 98104

Tel: (206) 296-4774: Direct: (206) 263-817]: Fax: (206?) 296?4803

E-mail: if" 

  

From: Bresee, Joseph ?imsy?

Sent: Saturday, February 22, 2020 10:56 AM

To: Duchin, Langley, Gayle E. 


Subject: RE: sentinel surveillance updates

 

Email Noticel External communication is important to us. Be cautious of phishing attempts. Do not
click or open suspicious links or attachments.

 

 

Gayle,

Can we add a section in the concept note for de?id?ed sample collection and testing. Not for the note
going to FDA, but for the group? Beyond allowing Jeff cover to stand this up, will be good to
document the plans in general. I suspect that this document will be added to over time to include
comms plans, for instance. So can treat the document that went to FDA as a static product at this
point, but acknowledge that the concept document/protocol may change over time.

Joe

From: Duchin, Jeff <Jeff.Duchin @kingcountv.eov>

Sent: Saturday, February 22, 2020 1:26 PM

To: Langley, Gayle E. 27 . 
Cc: Bresee, Joseph 
Subject: Re: sentinel surveillance updates

OK, is that possible? Not sure we can go forward if this is not consistent with guidance.

 

 

Jeffrey S. Duchin. MD (he/him)

Health Officer and Chief. Communicable Disease Epidemiology Immunization Section
Public Health - Seattle and King County

Professor in Medicine. Division of Infectious Diseases. University of Washington
Adjunct Professor. School of Public Health

401 5th Ave. Suite 1250. Seattle, WA 98104

Tel: (206) 296-4774; Direct: (206) 263-8171: Fax: (.206) 296-4803

E-mail: ff if" 

    

From: Langley, Gayle E. 
Sent: Saturday, February 22, 2020 10:24 AM
To: Duchin, Jeff 

Cc: Bresee, Joseph 
Subject: RE: sentinel surveillance updates

 

Email Notice! External communication is important to us. Be cautious of phishing attempts. Do not
click or open suspicious links or attachments.

 

 

 

Hello Jeff. The guidance was written collecting identified specimens. We did not create guidance for
de?identified specimens. ??gayle

From: Duchin, Jeff 

Sent: Saturday, February 22, 2020 12:56 PM

To: Langley, Gayle E. Bresee, Joseph


Subject: Re: sentinel surveillance updates

just noticed that the protocol does not have an option for deidentified that
intentional or an omission? lcan't move this forward here without the CDC 

 

Jeffrey S. Duchin, MD (he/him)

Health Of?cer and Chief. Communicable Disease Epidemiology Immunization Section
Public Health - Seattle and King County

Professor in Medicine. Division oflnfectious Diseases. University of Washington
Adjunct Professor. School of Public Health

40] 5th Ave, Suite 1250. Seattle. WA 98104

Tel: (206) 296-4774: Direct: (206) 263-8171: Fax: (206) 296-4803

E?maii: 

From: Langley, Gayle E. 

Sent: Thursday, February 20, 2020 1:58 PM

To: Balter, Sharon (CDC health.nyc.gov) Bresee, Joseph
Christine Mahle Conover, Craig
(CDC illinoisgov) Duchin, Jeff Ghinai,

From= BMW

To: WW: MD in
Subject: RE: Sentinel Surveillance

Date: Saturday, February 22, 2020 6:03:33 AM

 

Email Notice! External communication is important to us. Be cautious of phishing attempts. Do not
click or open suspicious links or attachments.

 

 

 

Hello. We can clarify what is meant by genetic tests. --gayle

From: Bresee, Joseph <jsb6@cdc.gov>

Sent: Saturday, February 22, 2020 9:02 AM

To: Duchin, Jeff (CDC kingcountygov) <jeff.duchin@kingcounty.gov>
Cc: Langley, Gayle E. <fez7@cdc.gov>
Subject: RE: Sentinel Surveillance

Jeff, yes, we can accept nasal swabs for surveillance either from prospective or retrospective
samples. See below for other thoughts 
joe

From: Duchin, Jeff< ff. hin kin . 

Sent: Friday, February 21, 2020 11:28 PM

To: Bresee, Joseph Langley, Gayle E.


Subject: Sentinel Surveillance
Joe, Gayle,

Had a discussion with Seattle Flu Study (SFS) team tonight. Because subjects were not
consented for follow?up implications of infection they are only able to provide de-
identified specimens at this time. We will draft a proposal for submission of de~identified
specimens if we get the word that aliquots from nasal swabs are permissible. Yes, this is
acceptable Will want to work with your communications team and the other jurisdictions
doing de-identified testing to have a consistent message with CDC commenting in the event of
a positive. working on something this weekend. Will share with the group

Also want to confirm with you that the UW researchers are free to test their study specimens
using their own in-house assay as long as they do not report results to patient or clinician.
That is Ok with us. Can they inform me and/or WA DOH of their results as long as we do not
use them as the basis for any action? My understanding (but will check again) is that you cant
use for clinical decisions or actions for the person, but I think it is OK to inform public health
actions for a population. Will ask around again this AM We would need to be sure they are
not able to link their result to the specimens submitted to CDC. i also serve as an advisor to

SFS, that makes it a bit complicated (or maybe less complicated?).

And finally, the patient info form says no genetic testing will be done on the specimen,
although that would preclude viral genetic analysis. I assume you meant no genetic testing on
human DNA, not viral RNA if so, perhaps that should be clarified?let Gayle responsd

I am also exploring prospective surveillance with other community clinics.Thanl<s

Thanks for your help.

Jeff

(PS Gayle - I just figured out your name change because my auto?populate email system pulls
up your prior surname when I enter fez? so, hello, nice to be working with you!

 

Jeffrey S. Duchin, MD (he/him)

Health Of?cer and Chief, Communicable Disease Epidemiology Immunization Section
Public Health - Seattle and King County

Professor in Medicine. Division of Infectious Diseases. University of Washington
Adjunct Professor. School of Public Health

40] 5th Ave. Suite 1250. Seattle. WA 98104

Tel: (206) 296?4774: Direct: (206) 263-8171: Fax: (206) 296-4803

E-mail: 

From: Quchlqu?

To: 
Cc: WW: Miriam: We
Subject: RE: COVID-19 sentinel surveillance protocol

Date: Monday, February 24, 2020 7:49:00 AM

Thanks, Joe. I do think it?s a bit different and perhaps more challenging message with de-identified
testing and limited follow-up. So far I?ve not been able to find a site willing to do identified but I?m
hoping that will be possible, so having a positive and not being able to do more testing may be a
problem. I've copied Scott because we?d need to know from WA DOH PHL what volume they could
test for this purpose as well and when that is going to be available. As for SFS, they said they can?t
do identified testing but we?re continuing to discuss to see if that can be modified via IRB-revision
request. Do we have a call today? It?s not in my calendar and I fly to Atlanta tomorrow, back FRI.

Sorry this is so complicated here.

Jeff

 

Jeffrey S. Duchin, MD

Health Officer and Chief, Communicable Disease Epidemiology Immunization Section
Public Health Seattle and King County

Professor in Medicine, Division of Infectious Diseases, University of Washington
Adjunct Professor, School of Public Health

401 5th Ave, Suite 1250, Seattle, WA 98104

Tel: (206) 296-4774; Direct: (206) 263-8171; Fax: (206) 296-4803

E-mail: jeff.duchin@kingcounty.gov

From: Bresee, Joseph <jsb6@cdc.gov>

Sent: Monday, February 24, 2020 3:13 AM

To: Duchin, Jeff Park, Sarah Y., MD 
Langley, Gayle E. Layton, Marci (CDC health.nyc.gov)
Layden, Jennifer (CDC illinoisgov) 
Lindquist, Scott SL (CDC doh.wa.gov) Jain, Seema (CDC cdph.ca.gov)
Weiss, Don (CDC health.nyc.gov) Balter,
Sharon (CDC ph.lacounty.gov) PGounder@ph.lacounty.gov; Meredith
Haddix Rakeman, Jennifer JR (CDC health.nyc.gov)
Christine Mahle Kauerauf, Judy (CDC
illinoisgov) Green, Nicole (CDC ph. acounty.gov)
Pathela, Preeti (CDC health.nyc.gov) 
Jessica Sell Conover, Craig (CDC illinoisgov) 
Ghinai, Isaac Hector Rivas Zahn, Matthew
DeWitt, Justin Thomas-Smith, Evonda
Lamb, Molly Cowgill, Karen 


Subject: RE: COVID-19 sentinel surveillance DRAFT protocol

From: in

T0: W191
Subject: Criteria for COVID-19 Testing

Date: Monday, February 24, 2020 9:32:00 AM

Given the challenges in getting sentinel surveillance up and running and the limited nature of that, I
think we should consider loosening criteria for PUI testing in some way or travel or both)
for non-severely ill patients analogous to what was done for severely ill. This will help us better
understand unrecognized cases/transmission. ls this under consideration at 

Jeff

 

Jeffrey S. Duchin, MD
Health Officer and Chief, Communicable Disease Epidemiology Immunization Section

Public Health - Seattle and King County

Professor in Medicine, Division of Infectious Diseases, University of Washington
Adjunct Professor, School of Public Health

401 5th Ave, Suite 1250, Seattle, WA 98104

Tel: (206) 296-4774; Direct: (206) 263?8171; Fax: (206) 296-4803

E-mail: jeff.duchin@kingcounty.gov

Adjunct Professor. School of Public Health

401 5th Ave. Suite 1250. Seattle. WA 98104

Tel: (206) 296-4774: Direct: (206) 263?8171; Fax: (206) 296-4803
E-mail: kingcountygov

From: Mark] Rieder <mrieder@uw.edu>

Sent: Monday, February 24, 2020 4:25 PM

To: Duchin, Jeff Lindquist, Scott (DOH)
<scott.lindquist@doh.wa.gov>

Cc: Robin Prentice Jay Shendure Helen Chu
Lea Starita Paul Nevin <paul.nevin@gatesventures.com>
Subject: Research Testing

 

Email Notice! External communication is important to us. Be cautious of phishing attempts. Do not
click or open suspicious links or attachments.

 

 

 

Hi Jeffand Scott -

We have had some fragmented email threads, so I want to be clear that we are planning on starting
research testing of our SFS samples this week. I am confirming that Jeff has heard from CDC and we
are clear to do our testing and that Scott is also aligned.

As i mentioned, any research result will be confirmed with sequencing which would take up to 7
days. Communication of any aggregate research results more broadly would be in partnership with
CDC, and WA DOH.

We are setting up a meeting to further discuss results communication this but I want to get your
explicit confirmation in advance on testing.

Thanks
Mark

 

Email Notice! External communication is important to us. Be cautious of phishing attempts. Do not
click or open suspicious links or attachments.

 

 

 

 

Thanks, Jeff. Will get you the comms materials today to review and edit. I think that if we can agree
that an early case identified would need a response (more surveillance to understand the scope of
local circulation and case investigation to see if tied to a known case/exposure), we can also agree
that limited testing capacity makes this challenging. It doesn?t look like anyone will have enough
testing capacity to open up testing in large cities to anyone who wants it, so was hoping that each
site might identify a subset of sites or samples based on flu surveillance perhaps - that can be
tested, but which represents a larger subset than the initial 50/week and larger also in terms of area
but perhaps within expected number of test kits available ZOO/week?

I was hoping that with SFS, you all might have a solution there.

Thanks for the comments and feedback. Talk later today
joe

From: Duchin, Jeff <Jeff.Duchin@kinecountv.eov>
Sent: Sunday, February 23, 2020 10:29 PM
To: Bresee, Joseph Park, Sarah Y., MD
<Wx Langley, Gayle E. <fez7 @gdg. ng Layton,
Marci (CDC health. gov) )Hmlavto nl@bea 1b (351;,ng Layden, Jennifer (CDC illinois. gov)
nif i i Lindquist, Scott SL (CDC doh. wa. gov) 
Jain, Seema (CDC ca. gov) <Seema,,iain nh@cdp .ca,gov>, Weiss, Don (CDC health. nyc. gov)
Balter, Sharon (CDC ph. lacounty. gov) <5bal Ig[@ph 
Meredith Haddix Rakeman, JenniferJR
(CDC health. nyc. gov) (irakem Christine Mahle <cm mahngh galth ng 
Kauerauf, Judy (CDC illinois. gov) <W??mgox>; Green, Nicole (CDC ph lacounty. gov)
Pathela, Preeti (CDC health. nyc. gov) 
Jessica Sell <isell?healtmicgm>; Conover, Craig (CDC illinoisgov) 
Ghinai, Isaac Hector Rivas Zahn, Matthew
DeWitt, Justin ng>; Thomas-Smith, Evonda
<Einda, I Lamb, Molly Cowgill, Karen <13;
Wam>
Subject: Re: sentinel surveillance DRAFT protocol

Thanks very much, Joe. I took a quick look and made a few comments. Unfortunately I'm the
only one available to work on this here currently, although we were fortunate to be able to
just have Karen Cowgill (who some of you may know from her CDC days) join us as surge part-
time epi help for this project and I added her to the email recipients. The two main issues for
us are the need for robust communication plan/messages for public and HCP in the event of a
positive, with associated guidance/actions for public and HCP. In response to Gayle?s
question, we would need to review communication and guidance and vet to some degree
locally before sending specimens. In addition, we will need to know more about how

enhanced surveillance post?positive will work since we don't have a pre-existing system in
place and don?t have resources to do anything complicated. The idea of only testing from
some clinics may not be acceptable to our community after a positive is detected (especially
with de-identified), I anticipate allowing all clinics to send specimens that meet some criteria
would be more acceptable if capacity to test allows that. This is such a gnarly problem
without adequate testing capacity.

Thanks you and Gayle for putting this together, I hope it works out that we can participate. I?ll
be in Atlanta this week at ACIP and even slowerthen usual to respond to email.

Jeff

 

Jeffrey S. [)uchin. MD (he/him)

Health Officer and Chief. Communicable Disease Epidemiology Immunization Section
Public Health - Seattle and King County

Professor in Medicine. Division of infectious Diseases. University of Washington
Adjunct Professor. School of Public Health

401 5th Ave. Suite 1250. Seattle. WA 98104

Tel: (206) 296- 4774: Direct. (206) 263- 8171: Fax: (206) 4803

E-mail: WW

From: Bresee, Joseph <lsp?mm>

Sent: Sunday, February 23, 2020 3:45 PM

To: Park, Sarah Y., MD Langley, Gayle E. 

f.ezZ@cdc ng; Layton Marci (CDC health. nyc. gov) <m aythQ@hea th. Layden, Jennifer

(CDC illinois. gov) <ierI ifer.laydep@ill iQQingv v> Lindquist, Scott SL (CDC doh. wa. gov)

Jain, Seema (CDC cdph. ca. gov) <?QQma n@gdph .Qa. ng; Weiss

Don (CDC health.nyc.gov) mmcc?hea?mwx Balter, Sharon (CDC ph. acounty.gov)
< rspatg @Qh. IacQun nty. ng>; @pragQiin ty.ng v< P'nGQii der @Qh.l agQiiQIy,ng>; Meredith
Haddix Rakeman, Jennifer JR (CDC health. nyc. gov)
<Wx Christine Mahle Kauerauf Judy (CDC

illinois. gov) aiieraii f@i lIiQQi IS. ng> Green Nicole (CDC ph. lacounty. gov)
<nEgceea?pthu?lLsL>; Pathela, Preeti (CDC health. nyc. gov) <ppatbela@ gaith. my; ng 

Jessica Sell Conover, Craig (CDC illinois. gov) 

Ghinai, Isaac Hector Rivas Zahn, Matthew

Duchin, Jeff <J??luugmi?gcgumygovz DeWitt, Justin

Thomas-Smith, Evonda Lamb,

Molly 

Cc: Bresee, Joseph Langley, Gayle E. 

<fez 2 (Q 
Subject: RE: sentinel surveillance DRAFT protocol

 

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click or open suspicious links or attachments.

 

 

 

All, We had a few tasks following the last call. Wanted to report out on mine. (Gayle will share the
latest protocol and the deidentified testing text, and updates on her progress over the weekend).

-Comms planning Working with Comms group re two deliverables to share with you all re
the surveillance collaboration?s goals and structure (to have before the 15t case is identified and

messages to have ready once the 1St case is identified. Hope to share these tomorrow for your
input and use to create your own materials.

?Document that outlines what happens once the 1St case is identified this is based on the transition
document I shared a few days ago. Was envisioning a more operational plan, that augments the
more conceptual plan I shared. Have attached a first stab at this. Will add a table to make simpler,
but please edit and comment on this one. It ends at the 1st detections, and needs another step?
triggers for transitioning more fully to community and health care mitigation from early case
containment and control management. But this will be next

-Funds working on this still to get clarity re timing. Assume that funding for surveillance and
response to states will come, at least initially, through ELC Coags, and assume that section will be
used. Will keep you updated re steps and timing.

Finally, feel free to send stored, de?identified samples when you are ready. We are happy to receive
and eager to get started!

Thanks
Joe

Joseph Bresee, MD
Dep. Incident Manager
2020 CDC nCoV Response

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Subject: Re: updates on sentinel surveillance activities

Date: Tuesday, February 25, 2020 5:20:52 AM

Thanks. Sarah. I assume our actions will follow from the revised community mitigation
guidance and associated triggers CDC is working on for COVID-19. A main challenge is for
us doing enhanced surveillance if we get a positive. We don't currently have a network of flu
surveillance sites we can tap into and would need to create dc novo while addressing other
response activities with too few staff/resources.

Jeffrey S. Duchin, MD

Health Officer and Chief, Communicable Disease Epidemiology Immunization Section
Public Health - Seattle and King County

Professor in Medicine. Division oflnfectious Diseases. University of Washington
Adjunct Professor, School of Public Health

401 5th Ave, Suite 1250, Seattle, WA 98104

Tel: (206) 296-4774; Direct: (206) 263-8171; Fax: (206) 296-4803

E-mail: jeff.duchin@kingcountygov

 

From: Park, Sarah Y., MD <sarah.park@doh.hawaii.gov>

Sent: Tuesday, February 25, 2020 1:25:26 AM

To: Bresee, Joseph Langley, Gayle E.
Arwady, Allison AA (CDC cityofchicagoorg)
Balter, Sharon (CDC ph.lacounty.gov)
Brian Hiatt Christine Mahle
Christopher Shields Conover,
Craig (CDC illinoisgov) Debra Wadford
Duchin, Jeff Desmond, Edward
Gail Cooksey Ghinai, Isaac
Godfred Masinde Green, Nicole (CDC
ph. acounty.gov) Hector Rivas Jain, Seema
(CDC cdph.ca.gov) Jessica Sell Justin DeWitt
Kauerauf, Judy (CDC illinoisgov) Kuhnert-
Tallman, Wendi Layden, Jennifer (CDC illinoisgov)
Layton, Marci (CDC health.nyc.gov) 
Leslie Chapman Lindquist, Scott SL (CDC doh.wa.gov)
Marelle Fricchione 
Meredith Haddix Molly Lamb 
PGounder@ph.lacounty.gov Rakeman, Jennifer JR (CDC
health.nyc.gov) Rose, Laura E. 

 Black, Stephanie SB (CDC cityofchicagoprg) 
Thomas-Smith, Evonda Vagi, Sara J. 
Weiss, Don (CDC health.nyc.gov) Zahn, Matthew
<MZahn@ochca.com>

Cc: Gregory Langley, Gayle E.
Bialek, Stephanie R. 
<zqg7@cdc.gov>

Subject: RE: updates on sentinel surveillance activities

 

(EXTERNAL Email Notice! 1 External communication is important to us. Be cautious of phishing attempts. Do not
click or open suspicious links or attachments.

 

 

 

Added just a couple comments to distinguish from my previous comments you kept in the
document. Regarding social distancing measures, the challenge may be getting people to adhere to
them if they?re difficult to maintain. Distance learning sounds ideal, but unless work places can all
accommodate a parent working at home to watch their child, that may not work. Then, there?s the
question of what exactly is the role of children in transmission. if they?re tending to be
and have little or no role, then great. If they?re but have
even some role in transmission, then that?s going to be a huge challenge.

Sarah Y. Park, MD, FAAP

State Epidemiologist

Chief, Disease Outbreak Control Division
Hawaii Department of Health

?n ounce ofiprevention is worrfi apound?ofcure. - Benfamin franl?lifn.

?Like? us on the BMW

5% Please consider the environment before printing this e-mail or attachments.

From: Bresee, Joseph <jsb6@cdc.gov>

Sent: Monday, February 24, 2020 3:42 PM

To: Langley, Gayle E. Arwady, Allison AA (CDC
cityofchicago.org) Balter, Sharon (CDC ph.lacounty.gov)
Brian Hiatt Christine Mahle
Christopher Shields Conover,
Craig (CDC illinois.gov) Debra Wadford
Duchin, Jeff (CDC kingcountygov) 
Desmond, Edward Gail Cooksey 
Ghinai, Isaac Godfred Masinde Green,
Nicole (CDC ph.lacounty.gov) Hector Rivas 
Jain, Seema (CDC cdph.ca.gov) Jessica Sell 
Justin DeWitt Kauerauf, Judy (CDC illinois.gov)
Kuhnert-Tallman, Wendi Layden,
Jennifer (CDC illinoisgov) Layton, Marci (CDC health.nyc.gov)

 Leslie Chapman Lindquist, Scott SL (CDC
doh.wa.gov) Marelle Fricchione
Meredith Haddix Molly
Lamb Rakeman, Jennifer JR (CDC
health.nyc.gov) Rose, Laura E. 
Park, Sarah Y., MD Black, Stephanie SB (CDC
cityofchicagoorg) Thomas-Smith, Evonda <Evonda.Thomas-
Vagi, Sara J. Weiss, Don (CDC
health.nyc.gov) Zahn, Matthew <MZahn@ochca.com>

Cc: Bresee, Joseph Gregory
Langley, Gayle E. 
Bialek, Stephanie R. <zqg7@cdc.gov>

Subject: RE: updates on sentinel surveillance activities

All,

Here is the revised version of the document re actions to take now and when a first case is identified
in the community for your review. Has more info that represents upcoming CDC thoughts on Comm
Mitigation and Health care mitigation. Can make into a table or figure to make more approachable
but wanted to get agreeable content first. See what you think and if this is useful for your own
planning

Re comms have submitted edits on all comms materials tonight back to CDC Comms folks. Will let
them incorporate that will share with you all tomorrow AM

I think that we have all agreed on a few principals 

-we all have a joint Comms plan, with local jurisdictions being in the lead and CDC supporting you all
(that you would announce anything frist)

-we have a shared understanding of what actions would be taken if positives are found the
attached doc is for that purpose but we acknowledge that we will convene when positives occur
and think through together as things will change

will support investigation of early cases as requested by you all.

Finally, I would ask that you all think through funding required for surveillance and response for this
project to be ready if and when asked for a proposal by CDC

Finally (really) Greg will be joining the response in my place starting tomorrow. I will
linger a bit to support this project but Gayle will continue as CDC FCC, and Greg and Stephanie
Bialek (EPl-Task Force Lead) will be more present in the discussions going forward. i will fade out for
a while but back soon. If you all can include Greg on emails to me, that would be great

Thanks again
Joe

Joseph Bresee, MD
Deputy Incident Manager
CDC 2020 nCoV response

From= 

To: 591mm; 
Cc: Qatlin?elt; mm mm mm
Subject: Re: Sentinel surveillance samples from Paul

Date: Wednesday, February 26, 2020 12:37:46 PM

That is ?ne ifthey are flu-negative and deidenti?ed. I?m assuming the specimens will all be
submitted correct? Would like the demographic info in
these.

The number of specimens that can be sent to CDC will be limited, especially initially and if
we also have sites that will do identi?ed sample submission (that?s not de?nite at the moment
but we are trying). Subsequently WA PHL will be able to handle more specimens, Scott will
need to tell us what that number will be for sentinel surveillance/deidentifed. esp once CDC
relaxes testing criteria allowing more submissions from clinicians.

Jeff

Jeffrey S. Duchin. MD
Health Of?cer and Chief, Communicable Disease Epidemiology Immunization Section
Public Health - Seattle and King County
Professor in Medicine, Division of Infectious Diseases, University of Washington
Adjunct Professor. School of Public Health
401 5th Ave, Suite 1250, Seattle, WA 98104
Tel: (206) 296-4774; Direct: (206) 263-817l: Fax: (206) 296-4803
E-mail: jeff.duchin@kingcounty. gov

 

From: Helen Chu <helenchu@uw.edu>

Sent: Wednesday, February 26, 2020 3:27:43 PM

To: Swanson, Paul Duchin, Jeff <Jeff.Duchin@kingcounty.gov>
Cc: Caitlin Wolf <crwolf@uw.edu>

Subject: Sentinel surveillance samples from Paul

 

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Hi Jeffand Paul,
lam sitting here talking to Paul and we are discussing the King County sentinel surveillance samples.

It sounds like these are collected for influenza-like illness, and we were hoping to include these
samples as part of the deidentified set we will consider sending to CDC.

Is that alright with all? The samples are already stripped of identifiers, and we are IRB approved for
testing.

Helen

Helen Y. Chu, MD MPH
Division of Allergy Infectious Diseases
chulab.org

From= Balsam

To: 

CC: EMA: Pr moccasins; istaiita; Bsu _Nean: WWO):
IstaLita; We; Wm; 

Subject: Re: Research Testing

Date: Thursday, February 27,2020 9:28: 13 AM

. - . 

 

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click or open suspicious links or attachments.

 

 

 

Thanks Jeff for sending. These are the three possible scenarios for how to get the tubes
deidentified and to CDC:

Issues the current sample is in a tube that has an embedded barcode.
Options:
1. Keep as is. issue is (remote) possibility of reidenti?cation of virus-positives. However
the UW team does not know results of testing so this is unlikely.
2. Uncap and realiquot into new tube with new label for CDC. Issue is adds a freeze-
thaw, introduces contamination/error risk. Extra tech time.
3. Cover with new sticker. Issues: adds a freeze-thaw. Extra tech time (not as much as



Helen

Helen Y. Chu, MD MPH
Division of Allergy infectious Diseases

chulab.org
*Our lab has moved to a new location in South Lake Union*

From: Jeff Duchin <jeff.duchin@kingcounty.gov>

Date: Wednesday, February 26, 2020 at 6:10 PM

To: Helen Chu Mark Rieder <mrieder@uw.edu>

Cc: Robin A Prentice Jay Shendure lstarita
Paul Nevin "Kay, Meagan"
"Cowgill, Karen? 
<scott.lindquist@doh.wa.gov>

Subject: Re: Research Testing

Here is the CDC project descrtiption for the sentinel surveillance.

 

JeiT're) S. Duchin MD (he/him)
Health Officer and Chiet. Communicable Disease 1 pidemiolng) immunization Section

Public Health- Seattle and King ount)

Professor in Medicine. Division of Infectious Diseases. University of Washington
Adjunct Professor. School of Public Health

40] 5th Ave. Suite 1250. Seattle. WA 98104

Tel: (206) 296-4774: Direct: (206) 263-8171: Fax: (206) 296-4803

Ii-mail: gov

From: Helen Chu <helenchu@uw.edu>

Sent: Wednesday, February 26, 2020 8:11 AM

To: Duchin, Jeff Mark Rieder Lindquist, Scott 
(DOH) <scott.lindquist@doh.wa.gov>

Cc: Robin A Prentice Jay Shendure Istarita
Paul Nevin Kay, Meagan
Cowgill, Karen 

Subject: Re: Research Testing

 

Email Notice! External communication is important to us. Be cautious of phishing attempts. Do not
click or open suspicious links or attachments.

Ok that sounds reasonable. They are already essentially stripped of identifiers. We would just need
to break the link. We can do this - but will have to do so carefully so there?s no risk of

 

 

reidentification.

Get Qutlook for ing

From: Duchin, Jeff <Jeff.Duchin @kingcounty.gov>

Sent: Tuesday, February 25, 2020 5:59:37 PM

To: Mark Rieder Lindquist, Scott (DOH) 
Cc: Robin A Prentice Jay Shendure Helen Chu
Istarita Paul Nevin 
Kay, Meagan Cowgill, Karen 
Subject: Re: Research Testing

Spoke with CDC tonight about research testing (not sentinel surveillance work). They wanted
to be sure if you do identified testing with research assay that your IRB is aware that no
follow-up action will be taken for positives, in conflict with current PH guidance. They
suggested you may want to de-identify for your own research assay work as well to avoid that
issue. On my main question of what research assay results SFS can report to PH, they are
going to get an answer from FDA tomorrow and HI pass it along.

Jeff

 

Jeffrey S. Duchin. MD (heihirni
Health Of?cer and Chief. Communicable Disease Epidemiology Immunization Section

Public Health - Seattle and King County
Professor in Medicine. Division oflnfectious Diseases. University of Washington

 

+1 646 876 9923 US (New York)
Meeting ID: 265 821 853

On Thu. Feb 27. 2020 at 10:50 PM Helen Chu <hejenchu@ym_e_d_u> wrote:

Let's all plan to be on a 9:00 am call tomorrow to discuss this. Robin. can you set up a zoom
call and include whoever else should join from the SFS team.
Thank you.

Get 

- -.. .. 

From: Kuhnert-Tallman, Wendi <wdk1@gdc.gov>

Sent: Thursday, February 27, 2020 8:19 PM

To: Duchin, Jeff (CDC W)

Cc: Helen Chu; Janet Englund Lindquist, Scott SL
(CDC time-gm): Cowgill, Karen

Subject: Re: SEATTLE Flu Study Lab Result

Thanks much Jeff for connecting us. Happy to make the time any time - 7:30 your time is
?ne but I will wait to see the calendar invite to con?rm.

Thanks!

Get QJILQQKIQUQS

From: Duchin, Jeff f.D kin 
Sent: Thursday, February 27, 2020 11:17:20 PM
To: Kuhnert-Tallman, Wendi <wdk] @gdg ng>

CC: Helen Chu Janet Enalund (WW)
Lindquist, Scott SL (CDC W)
Cowgill, Karen <n?kgowgill@kinggountygow

Subject: SEATTLE Flu Study Lab Result

Wendy,

Thanks for helping us navigate with FDA colleagues what we can say/do in response to a
potential positive test result from the SFS research assay. Helen Chu and Jan Englund are
the SFS researchers that can provide the details of the test method and other relevant
information. l?m also copying Scott Lindquist. the WA State DOH communicable disease
epidemiologist and Karen Cowgill who works on surveillance with us. It probably would

be good to have a call early tomorrow Paci?c time (7:30) but Helen and Jan should schedule

the time with you.
Very much appreciate your help.

Jeff
Jeffrey S. Duchin, MD

 

 if testing continues, what is the flow of information to public health re?contacting patients with
resuits

- any other relevant info was the lot of the kit SFS used to confirm their initial positive the same
lot that CDC had 

Thank you,

Karen Cowgill, (she/her)

Response Epidemiologist

Communicable Disease Epidemiology Immunization Section

Public Health - Seattle and King County

Affiliate Assistant Professor in Global Health, University of Washington
401 5th Ave, Suite 1250, Seattle, WA 98104

Tel: (206) 296-4774,- Direct: (206) 263-3087; Fax: (206) 296-4803

E-maii: n-kcowgiil@kingcountygoy

From: MarkJ Rieder <mrieder@uw,edu>

Sent: Thursday, February 27, 2020 10:57 PM

To: Helen Chu <hd?ghg?um??u>

Cc: Kuhnert-Tallman, Wendi Duchin, Jeff
(MWZ Robin A Prentice rwobins?@u .edu>; Janet Englund

(ianetgn glund@seattlechildrens.org) <Wmdremgx Lindquist, Scott SL
(CDC doh. wa. gov) Cowgill, Karen Jay
A. Shendure Trevor Bedford <mLmedfoL?m>; Istarita <_s_te_taMd_Q>
Subject: Re: SEATTLE Flu Study Lab Result

 

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click or open suspicious links or attachments.

Here is the Zoom link for the call in tomorrow (Friday. 2/28 9 am PT)

Mark Rieder is inviting you to a scheduled Zoom meeting.

 

 

Topic: CDC Call
Time: Feb 28, 2020 09:00 AM Paci?c Time (US and Canada)

Join Zoom Meeting
l' 

Meeting ID: 265 821 853

One tap mobile
+16699006833,,265821853# US (San Jose)
+16468769923,,265821853# US (New York)

Dial by your location
+1 669 900 6833 US (San Jose)

 

 

Best,
Tom;

Timothy T. Stenzel, MD, 
Director: OH T7: Office of in Vitro Diagnostics and Radiological Health
Office of Product Evaluation and Quality

Center for Devices and Radiological Health
U.S. Food and Drug Administration


)ennifer Campbell

Administrative Assistan 

0HT7: Of?ce of in Vitro Diagnostics and Radiological Health
Of?ce of Product Evaluation and Quality

CDRH Food and Drug Administration
White Oak, Bldg. 66 3403 10903 New Hampshire Avenue I Silver Spring, MD 20993
Ph: 301-796-7692

Leuniiec?amphemfdabhsm

Excellent customer service is important to us. Please take a moment to provide feedback regarding the customer service you
have received: :i

From: Cowgili, Karen (MW)

Sent: Friday, February 28, 2020 4:46 PM

To: Marki Rieder Helen Chu mam? Stenzel, Timothy
Langley, Gayle (CDC) Kuhnert~Tal man, Wendi 
(CDC) <Mgox>; Duchin, Kay, Meagan


Cc: Robin A Prentice <W?z Janet Englund (MW)
Lindquist, Scott SL (CDC doh.wa.gov)
Jay A. Shendure Trevor Bedford
Istarita w. 

Subject: RE: SEATTLE Flu Study Lab Result

Importance: High

Hi Tim, et al. at CDC and Mark, et al. at SFS Jeff Duchin (Chief Health Officer at Public Health
Seattle?King County) asked me to follow up with you about the outcome of our discussion earlier
today (9 ET) about Seattle Flu Study testing for 

At the end of the call, Tim said he would get back to Mark within the hour, but we haven?t heard
anything on our end.

Could someone please send a summary of where things stand and specifically
what the current guidance is about SFS continued testing of samples for nCoV (retrospective and

prospective)

<mg1gLQuJ?gz Helen Chu <heln en hwu@u dedu> Langley, Gayle (CDC) 
Kuhnert? Tallman, Wendi Duchin, g@kin IggQun Kay,
Meagan 

Cc: Janet Englund WW) . il 
Lindquist, Scott SL (CDC doh.wa.g0y) <m1immsj?dgumgmz Jay A. Shendure
<5henduce?mdu? Trevor Bedford Istarita 

Subject: RE: SEATTLE Flu Study Lab Result

 

Email Notice! External communication is important to us. Be cautious of phishing attempts. Do not
click or open suspicious links or attachments.

 

 

 

Sounds good.

From: Robin A Prentice <robins4@uw.edu>

Date: February 29, 2020 at 12:44:15 PM EST

To: Stenzel, Timothy <?mmhy?1en1el?tdah?sgmz Cowgill, Karen 
Mark Rieder (Wz Helen Chu Langley, Gayle (CDC)
Kuhnert?Tallman, Wendi (CDC) Duchin, Jeff
Kay, Meagan ng>

Cc: Janet Englund (WW9 
Lindquist, Scott SL (CDC dohwagov) <5ggn; Jay A. Shendure
Trevor Bedford Istarita 

Subject: RE: SEATTLE Flu Study Lab Result

Hello Tim,

Would it work for us to talk at llam Pacific time, 2pm Eastern? I will send a zoom invite in a
moment.

Robin

From: Stenzel, Timothy 
Sent: Saturday, February 29, 2020 9:11 AM

To: Cowgill, Karen Mark Rieder <mriedgr @uw .ediP; Helen Chu
<he  enchu@uw ,edu>; Langley, Gayle (CDC) <fez7 @cdcgop, Kuhnert- Tallman, Wendi (CDC)
<35;ko @ch amp; Duchin Jeff Kay, Meagan


Cc: Robin A Prentice robins4@uw .ung Janet Englund 
Lindquist, Scott SL (CDC doh. wa. gov)
Jay A. Shendure <?mm2 Trevor Bedford
Istarita Isgar rita@?w 

Subject: RE: SEATTLE Flu Study Lab Result

Hi,

Can one or more folks from the Seattle Flu Study lab give me a call on my cell 202-308?9464? Leave a
VM with number to get back to you right away if it goes to VM.

Thanks!

Best,
Tr

Timothy T. Stenzel, D, 
Director. Of?ce of in Vitro Diagnostics and Radiological Health
Office of Product Evaluation and Quality

Center for Devices and Radiological Health
U.S. Food and Drug Administration
Tim . I

lennifer Campbell
Administrative Assistant

0HT7: Of?ce ofln Vitro Diagnostics and Radiological Health
Of?ce of Product Evaluation and Quality

CDRH I Food and Drug Administration

White Oak, Bldg. 66 34-03 10903 New Hampshire Avenue Silver Spring, MD 20993
Ph: 301-796-7692



Excellent customer service is important to us, Please take a moment to provide feedback regarding the customer service you

have received:h :i i =1 

From: Stenzel, Timothy 

Sent: Saturday, February 29, 2020 10:53 AM

To: Cowgill, Karen <n - MarkJ Rieder Helen Chu
iiwelenctJuQu ego); Langley, Gayle (CDC) Kuhnert- Tallman, Wendi (CDC)
Duchin Jeff Kay, Meagan

gagan ISanki 1y ng v>

Cc: Robin A Prentice Janet Englund Wm)
Lindquist, Scott SL (CDC doh.wa.gov)
Jay A. Shendure Trevor Bedford
lstarita 

Subject: RE: SEATTLE Flu Study Lab Result

Hi Karen,
I did connect with Mark a little after an hour yesterday by phone.

Wanted to let you know of this PR and linked new guidance thatjust was released.

We are still working on your particular situation.

 

From: 

T0: SW

Cc: 

Subject: FW: Flu Study Lab Result
Date: Friday, March 13, 2020 5:14:00 PM
FYI

 

  
  
 
 
  
  
 
  
 
  
  
  
  

Jeffrey S. Duchin, MD
Health Officer and Chief, Communicable Disease Epidemiolo
Public Health - Seattle and King County
Professor in Medicine, Division of infectious Diseases, Un' ersity of Washington
Adjunct Professor, School of Public Health

401 5th Ave, Suite 1250, Seattle, WA 98104

Tel: (206) 296-4774; Direct: (206) 263-8171; Fax: 
E?mail: jeff.duchin@kingcountygov

8a Immunization Section

From: Duchin, Jeff <Jeff.Duchin@kingcounty ov>
Sent: Saturday, February 29, 2020 10:09 A
To: Stenzel, Timothy <Timothy.Stenzel@f a.hhs.gov>; Robin A Prentice Cowgill,
Karen rk Rieder Helen Chu
Langley, Gayle (CDC) Kuhnert-Tallman, Wendi (CDC)
Kay, Meagan agan.Kay@kingcounty.gov>

Cc: Janet Englund (janetenglund eattlechildrensorg) 
Lindquist, Scott SL (CDC doh.wa. v) Jay A. Shendure
Trevor dford lstarita <lstarita@uw.edu>

Subject: Re: SEATTLE Flu Stu Lab Result

Hello folks we are overwh lmed here in the public health department and not able to join this call.
I?m hoping Karen can joi for us. It would be really fantastic if FDA can find a way to allow the SFS
study to continue to te a large number of samples to help us understand about community-based
transmission especiall in light of our current outbreak and other case with no travel history.

Jeffrey S. Duchin, MD
Health Officer and Chief, Communicable Disease Epidemiology 84 Immunization Section
Public Health Seattle and King County
Professor in Medicine, Division of Infectious Diseases, University of Washington
Adjunct Professor, School of Public Health
401 5th Ave, Suite 1250, Seattle, WA 98104
Tel: (206) 296-4774; Direct: (206) 263-8171; Fax: (206) 296-4803



 

From: Stenzel, Timothy <Tim . n2 I 
Sent: Saturday, February 29, 2020 10:01:01 AM
To: Robin A Prentice <mm?iu>; Cowgill, Karen Mark Rieder