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"VIP NeuroRehabilitation Center is a non-profit 501(c)(3) organization, run by and for the patients! We bring top quality outpatient NeuroRehabilitation care to disabled military, veterans, children, and to ALL who are in need.  Located in San Diego, California, we treat adult and pediatric patients, from ages 4 years old and up. Our focus is on those who have difficulty moving secondary to Stroke, Multiple Sclerosis (MS), Brain Injury, ALS, Cerebral Palsy, Spinal Cord Injury, and multiple traumas."

"Abstract Detection of SARS-CoV-2 infections to date has relied heavily on RT-PCR testing. However, limited test availability, high false-negative rates, and the existence of asymptomatic or sub-clinical infections have resulted in an under-counting of the true prevalence of SARS-CoV-2. Here, we show how influenza-like illness (ILI) outpatient surveillance data can be used to estimate the prevalence of SARS-CoV-2. We found a surge of non-influenza ILI above the seasonal average in March 2020 and showed that this surge correlated with COVID-19 case counts across states. If 1/3 of patients infected with SARS-CoV-2 in the US sought care, this ILI surge would have corresponded to more than 8.7 million new SARS-CoV-2 infections across the US during the three-week period from March 8 to March 28, 2020. Combining excess ILI counts with the date of onset of community transmission in the US, we also show that the early epidemic in the US was unlikely to have been doubling slower than every 4 days. Together these results suggest a conceptual model for the COVID-19 epidemic in the US characterized by rapid spread across the US with over 80% infected patients remaining undetected. We emphasize the importance of testing these findings with seroprevalence data and discuss the broader potential to use syndromic surveillance for early detection and understanding of emerging infectious diseases."

Explanation from DeAunne Denmark, MD, PhD : And just to clarify for all, since all of the testing jargon and landscape can be *extremely* confusing, especially now: The FDA has currently relaxed regulations for COVID diagnostics under "Emergency Use" (EUA). This authorizes, not approves, test kits, machines and devices to run those kits, and all other aspects involved in diagnostic testing. Authorize vs approve are very different animals under FDA. And you will see this repeatedly emphasized on the FDA site. But most often neglected, skipped over, mistaken in the wider press. Many articles and press releases use "approve" which is technically wrong - they mean authorize, or "grant use", or "use will not be objected to by FDA." If you have the stamina, I highly recommended reading as much of this as you can: https://www.fda.gov/medical-devices/emergency-situations-medical-devices/faqs-diagnostic-testing-sars-cov-2 "Validation" is yet an additional aspect that is probably the grayest zone of all, since it is left to each company/testing entity how exactly this is done. Validation can range from excellent to pretty cruddy science and still meet FDA "standards". These will be the devilish details we need to sort out re: collaborating with partners. And will unfortunately likely be a big mess for many outpatient Drs trying to figure out which test to order.

"How Will Coronavirus Patients Flow through Health Services? Many of you have called asking to be tested for Coronavirus. Given recent testing challenges, the CDC and County have provided physicians with a simple coronavirus patient testing & care health services flowchart. As you can see, if symptoms are mild, testing is not indicated at this time. It is my hope that we will soon be able to test everyone! The 211 number mentioned below is a San Diego County information line that helps people efficiently access appropriate services, and provides vital data and trend information. The website for 211 is https://211sandiego.org/"