How Far Has COVID-19 Spread in L.A.? He Looks for Answers

Neeraj Sood heard reports in winter of a new coronavirus in Asia, but he gave the virus little thought.

Then news trickled in about its alarming spread and the severe illness that sent patients to hospitals. The World Health Organization declared a pandemic, and parts of the U.S locked down. That’s when the USC professor’s health economics mindset kicked in.

How widespread were the infections, really? Was this disease much deadlier than the flu?

Because many virus carriers show few or no symptoms, testing only sick patients “will not get us to the truth,” he wrote in a Wall Street Journal op-ed. If the infection and death rates from the virus compare to the flu, the economic epidemiologist reasoned, lockdowns can be lifted sooner. “But if they’re much higher, drastic measures are imperative.”

Sood soon partnered with the Los Angeles County Department of Public Health to conduct one of the country’s first studies to test the blood of volunteers for antibodies to the new coronavirus. Through these seroprevalence studies, researchers estimate the spread of COVID-19 through the population.

The findings were surprising: Nearly 5% of Los Angeles County residents had contracted the new coronavirus.

When the World Puts Your Work Under a Microscope

The department tested nearly 900 county residents. When he presented preliminary results at a public briefing, it sparked a national conversation. He was on major news channels and media outlets.

The findings were surprising: Nearly 5% of Los Angeles County residents had contracted the new coronavirus, the study showed, far more than the confirmed case count suggested. That meant that many of the infected never showed symptoms and the death rate was lower than originally thought.

“I’ve never had my research reviewed or scrutinized by thousands of other researchers and receive the attention it has gotten. It wasn’t all friendly scrutiny,” he says of the findings. Critics of the stay-at-home orders seized upon the study results to argue their positions. Others questioned Sood’s methodology. “People have strong prior beliefs about the topic. They’re looking at the same research through different lenses.”

As is true for most research, he acknowledges that his study had limitations. But he is glad he tackled the research with urgency “because it is influencing the way a lot of people think about an important problem and spurring more research on a critical issue.” The peer-reviewed study was published in JAMA, the Journal of the American Medical Association.

Asking Provocative Questions to Make a Community Healthier

Sood isn’t looking for notoriety–or even publication in a scientific journal. He focuses on bringing new evidence to inform one of the most critical health challenges facing the world. That’s part of his role as co-founder of the USC Schaeffer Center for Health Policy and Economics. He joined USC from RAND, a leading think tank based in Santa Monica, California, and is now vice dean for research and faculty affairs at the USC Price School of Public Policy.

Sood is known for sharing ideas and debating research strategies good naturedly with fellow faculty. Other researchers praise his enthusiasm for working through scientific disagreements in the quest for answers.

His field of study — economics — offers a wealth of questions that beg for these answers.

Many people think economics is about money, but it’s more about human behavior and how we weigh choices, Sood says. As a health economics specialist, he aims to improve health care markets and find ways to give more people a chance at a healthy life, regardless of their background.

The thrill for Sood comes when he’s able to make a case for a policy change and then see that policy enacted. For example, health economists often debate whether health insurance improves health or just leads to more spending on care with little benefit. His project with the World Bank provided an answer.

A large state in India introduced health insurance for poor families in the northern half of the state. The insurance covered major surgeries and procedures–expenses that could be catastrophic if paid out of pocket. To understand the coverage’s potential effects, Sood sampled 100,000 households in the middle of the state, where about half had this kind of insurance coverage.

Turns out that health insurance matters, especially for the poor. “The villages that had health insurance had much lower mortality from cardiac disease and from cancer–exactly the type of care covered by the insurance program,” he says. Insurance also narrowed the mortality gap between rich and poor.

When the health secretary saw Sood’s results, he vowed to act on them. Within months, the insurance program expanded to the rest of the state.

“To me, that’s the kind of research that’s satisfying. We come up with something different or innovative, and then it actually influences how people think and leads to a change,” he says.

Neeraj Sood Eyes Tradeoffs in Coronavirus Pandemic

What’s next for Sood? The future offers opportunities to view the spread of COVID-19 through a health economics lens. For instance, researchers don’t fully understand the role of schoolchildren play in transmitting the new coronavirus. So when schools close due to the pandemic, are the health benefits worth the educational setbacks?

But that work will come later. These months at home have kept him busy cooking for his wife and fellow USC researcher, Ashlesha Datar, and their two daughters, ages 10 and 13. In pre-pandemic times, Sood’s workday ended at 6:30 p.m. and weekends were dedicated to family. But during the stay-at-home order, Zoom meeting followed Zoom meeting. He might take calls at 5 a.m. or 10 p.m.

“I usually don’t work weekends. I am feeling a little guilty,” he says. “I’m sure my daughters see I’m more tense. But at the same time, they are also seeing it matters, and when you want to do something this is how you get it done.

He also reports a development relatable to dads out there: “I recently got just a glimpse of my 13-year-old thinking that what I do is important.”

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