More interesting data regarding Covid

[Guest]

Wel

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This article highlights the difference between mitigation and suppression. I don’t recall goal being suppression back in March or April. Every other word out of Fauci’s mouth then was “mitigation.”

 

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I agree that in the US, the cat is out of the bag, and there are so many millions of Americans who are either carrying Covid-19 or have recovered, that suppression is not a reasonable goal. That being said, clearly allowing unmasked people in crowded bars, restaurants, and discotheques, the way they did it in Florida, Texas, and Arizona, was a big mistake. The reality is, hospitals were built with the idea of being about 80% full, including their ICU's. So they can be easily overwhelmed in case of disaster. Airlines don't make money when their planes have a lot of empty seats, and hospitals don't make money when they have a lot of empty beds. Although the virus appears to be less virulent at this time, some hospitals in those states have gotten near capacity, which could lead to disaster if mitigation measures aren't taken.

The crowded BLM marches have shown us that outdoor transmission is rare. So outdoor seating should be fine. I suspect that a restaurant with very lightly-populated indoor seating should be OK as well. But discos and bars, where the whole idea is to congregate, are an invitation for disaster (although most of the people infected are younger and unlikely to need hospitalization, they could easily pass it on to a more vulnerable population). I have a friend who caught Covid-19 going to a crowded disco in Houston over the Memorial Day week-end. I'm meeting him this week-end, and he's one man I can feel confident I have no risk being in close contact with.

It would be great to have a massive antibody testing for certain areas so we could get an idea of what proportion of the population has already been infected, and who remains at risk. We'll have to see what happens when the weather turns colder. Also, I've heard that many states plan to re-open schools. We'll have to keep a very close eye at the data and learn from the data, taking action accordingly. Good to see that death rates are continuing to fall, at least for now:

https://ourworldindata.org/grapher/daily-covid-deaths-per-million-7-day-average?country=~USA

[RealAvalon]

Airlines don't make money when their planes have a lot of empty seats, and hospitals don't make money when they have a lot of empty beds.

https://ourworldindata.org/grapher/daily-covid-deaths-per-million-7-day-average?country=~USA

Weird, thinking about hospitals "making money." Foreign concept for a Canadian.

[xyz48B]

It would be great to have a massive antibody testing for certain areas

That would be great but for some reason there is a lack of willingness to do that. Just like there’s a lack of willingness on the part of many places to do testing if you’re not symptomatic. I can understand testing only symptomatic folks if testing is an issue in a particular area, but for example in Massachusetts, our rate is so low that anyone who walks in (or drives in) should be able to get a test. We have the capacity, as per the governor. But many places are still limiting it to just symptomatic folks. And then we have the turn-around time on testing as well. Some places here are getting it done in 24 hrs. Others it’s still 3 days. What good is a negative test 3 days old if you don’t quarantine at home? I suppose that’s the point. Quarantine until you get the results, but it is extremely inefficient.

[xyz48B]

Weird, thinking about hospitals "making money." Foreign concept for a Canadian.

I had heard, uncorroborated, that hospitals with higher COVID counts could receive more federal money. I don’t know how true that is but I wouldn’t be surprised.

[Guest]

Weird, thinking about hospitals "making money." Foreign concept for a Canadian.

That being said, I doubt that hospitals are built in Canada with the intention of keeping a lot of empty beds, either. The money has to come from somewhere.

[RealAvalon]

That being said, I doubt that hospitals are built in Canada with the intention of keeping a lot of empty beds, either. The money has to come from somewhere.

Built for efficiency and better health outcomes.

 

During the beginning of the pandemic, March 16th, all elective surgeries were cancelled by the Ministry of Health, to free up space for potential pandemic response. This reduced surgeries to about 1,200 per week. Since May 15th elective surgeries have resumed, back-up to about 6,000 per week. The proportion of non-scheduled emergencies surgeries has remained constant at about 1,200.

 

Since entering phase three of re-opening, there has been an increase of COVID related hospitalizations, province-wide, from six people to 16 people, and ICU beds from two people to six people. Population 5.1 million.

[Guest]

Built for efficiency and better health outcomes.

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I'm not arguing that the Canadian system isn't more efficient and better-designed overall. However, when it comes to hospital beds, I think the end result is the same: probably build for 80% capacity most of the time. The reasons why the US was so hard-hit aren't all entirely clear. Much of it has to do with American hard-headedness and insistent on almost unlimited "rights," including the right to not wear masks, the right to party at a disco regardless of grandma's health risks, and so on. Also, of course, there were lots of people visiting the East Coast from Europe and the West Coast from China. I doubt Canada gets many visitors in March, when this hit, other than some skiers (and people rarely will fly from Europe or China just to ski).

[RealAvalon]

I'm not arguing that the Canadian system isn't more efficient and better-designed overall. However, when it comes to hospital beds, I think the end result is the same: probably build for 80% capacity most of the time. The reasons why the US was so hard-hit aren't all entirely clear. Much of it has to do with American hard-headedness and insistent on almost unlimited "rights," including the right to not wear masks, the right to party at a disco regardless of grandma's health risks, and so on. Also, of course, there were lots of people visiting the East Coast from Europe and the West Coast from China. I doubt Canada gets many visitors in March, when this hit, other than some skiers (and people rarely will fly from Europe or China just to ski).

Vancouver is an international city year-round, 100% hotel occupancy rates. From the genome analysis of virus strains from all of the infected people, it was determined the biggest contributor to our outbreak was an international dentist convention in early March - European and East Coast dentists arriving when the virus was spreading rapidly where they came from. Chinese variant, mostly caught at airport, and no community spread.

 

I expect our hospitals are operating at 95% capacity most of the time. More community health clinics are being opened, to try and get people in earlier and divert them from eventually showing up at emergency wards.

[Guest]

Interesting to see that while cases of Covid-19 are now indeed surging, the deaths continue to fall in the US. The reasons are unclear. Is it changes in the virus itself? Seasonality? The more vulnerable being more cautious?

 

https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html?campaign_id=9&emc=edit_nn_20200702&instance_id=19941&nl=the-morning&regi_id=121639701&segment_id=32426&te=1&user_id=98e698d7e00b3c0348927193de9ffeee

Edited July 2, 2020 by Unicorn

[mike carey]

Interesting to see that while cases of Covid-19 are now indeed surging, the death continue to fall in the US. The reasons are unclear. Is it changes in the virus itself? Seasonality? The more vulnerable being more cautious?

From what I've read, the prevalence of disease is among younger people now, so that will probably have an effect on the rate of deaths. Another thought is that the recent surge hasn't had enough time to flow through to affect the number of deaths. We should know whether that is a factor soon enough.

[+ bigjoey]

Yes, from what I read much of the spike in infections is among the young with seniors being more cautious in their daily lives.

 

America’s youth will win no prizes for intelligence when it comes to Covid19:

https://www.cnn.com/2020/07/02/us/alabama-coronavirus-parties-trnd/index.html

[+ WilliamM]

As a stage four cancer survivor, Herman Caine might have have been wise to wear a mask at politcal rallies.

[mike carey]

I've bought some surgical masks but haven't used them yet, my local shops are sufficiently uncrowded that I don't think it is necessary given our low level of infections. But I am still mindful of the need to be ready to wear them. With that in mind, I have ordered some cloth masks from a small company in Nova Scotia. They have a variety of provincial tartans and some other 'cute' cloth patterns in masks at CA$8 apiece. (In case you wondered, they have a pride mask.)

https://www.maritimetartancompany.ca/

If you choose to buy from them, let them know you are supporting them.

[+ Charlie]

I've bought some surgical masks but haven't used them yet, my local shops are sufficiently uncrowded that I don't think it is necessary given our low level of infections. But I am still mindful of the need to be ready to wear them. With that in mind, I have ordered some cloth masks from a small company in Nova Scotia. They have a variety of provincial tartans and some other 'cute' cloth patterns in masks at CA$8 apiece. (In case you wondered, they have a pride mask.)

https://www.maritimetartancompany.ca/

If you choose to buy from them, let them know you are supporting them.

I am more interested in how they feel than in what they look like. I have cloth masks from two different sources, a neighbor who makes them at home, and a company that makes them for medical workers. The former are more comfortable by far. As it heats up here in the desert summer, I am also finding that any kind of mask is uncomfortably hot outside during the day.

[SirBillybob]

Interesting to see that while cases of Covid-19 are now indeed surging, the deaths continue to fall in the US. The reasons are unclear. Is it changes in the virus itself? Seasonality? The more vulnerable being more cautious?

 

Apart from mortality lagging behind infection, and testing capturing greater numbers of less severe cases, I think the phenomenon of regression to the mean may partly explain this trend. I think @bigjoey is familiar with the concept. It has occurred worldwide and in many nations. Back to clarifying it in a second.

 

That it has not been as evident in countries with good measurement protocol earlier in the game suggests it is not viral genetic drift. Also as things get more out of control and new case rates speed up it is difficult to keep apace and add both probable but unconfirmed deaths and excess deaths reasonably attributable to Covid-19 to the overall mortality tally.

 

A better option to positioning rolling death against rolling new diagnoses is to review the death:recovery ratio for closed cases, ie known outcomes. This mortality rate curve for most jurisdictions has been descending in a less pronounced fashion compared to absolute deaths taken out of context of recoveries.

 

The ratio fluctuated widely early in the pandemic. You can also see this in the global ratio curves, though smoothed out as a function of averaging out the more pronounced early anomalies and marked ratio changes for individual countries.

 

As volumes increase, the death rate is want to gravitate towards the overall central tendency (ie, mean) that represents the overall 5-month average to date of death/recovery proportions, given also that measurement protocol also stabilizes and reduces overall error ... the discrepancy between observed values and true values. It just so happens that ‘regression to the mean’, a shift in the graph towards the most truly representative likelihood of fatality, has been downward, for all countries whose death curve was considerably variable across time early in the pandemic.

 

One way to discern it is this exact explanation will be an eventual levelling out of the ratio, that is a horizontal direction on the graph (rather than a deviation from horizontality), as has been seen in Germany, for example, or more so globally than nationally.

Edited July 2, 2020 by SirBIllybob

[RealAvalon]

From what I've read, the prevalence of disease is among younger people now, so that will probably have an effect on the rate of deaths. Another thought is that the recent surge hasn't had enough time to flow through to affect the number of deaths. We should know whether that is a factor soon enough.

It will also, probably, be an indicator that it'll be harder to get the virus contained, and reduce future deaths, because it's community spread, and not 'contained' in seniors facilities.

[+ keroscenefire]

Interesting to see that while cases of Covid-19 are now indeed surging, the deaths continue to fall in the US. The reasons are unclear. Is it changes in the virus itself? Seasonality? The more vulnerable being more cautious?

 

https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html?campaign_id=9&emc=edit_nn_20200702&instance_id=19941&nl=the-morning&regi_id=121639701&segment_id=32426&te=1&user_id=98e698d7e00b3c0348927193de9ffeee

 

I also think doctors and nurses know how to better treat the disease now than they did at the beginning. We now have two medications that we know help COVID patients with one drug dexamethasone proven to actually help reduce death rates (Remesdivir has only been shown to reduce the number of days in the hospital). These drugs with new knowledge on using oxygen and ventilators (and having more ventilators available) will likely prevent many more people from dying.

 

The thing I'm worried about is busting our hospital capacities. It appears to be happening in Arizona and Texas and probably Florida (they aren't actually releasing COVID hospitalization data so it's hard to say). If COVID patients can't get the care they need, the death rate may very well increase again.

[RealAvalon]

The thing I'm worried about is busting our hospital capacities. It appears to be happening in Arizona and Texas and probably Florida (they aren't actually releasing COVID hospitalization data so it's hard to say). If COVID patients can't get the care they need, the death rate may very well increase again.

Have they said why not? Our CDC has a live weblink, with continual updating of the numbers of hospitalizations and ICU beds used.

[+ bigjoey]

It’s official, the virus has mutated:

https://amp.cnn.com/cnn/2020/07/02/health/coronavirus-mutation-spread-study/index.html

 

This may make a vaccine harder to develop?

[SirBillybob]

The rolling fatality rate descent is slowing towards zero degrees from horizontal, as states with current ascending death rates adjust the tally. Two weeks ago it was 68% of the average recorded four weeks ago. Now it is 57% of the average recorded four weeks ago and 84% of the average from two weeks ago.

[+ keroscenefire]

It’s official, the virus has mutated:

https://amp.cnn.com/cnn/2020/07/02/health/coronavirus-mutation-spread-study/index.html

 

This may make a vaccine harder to develop?

 

The CNN article is synthesizing some information from studies that go as far back as March. This mutation has been the dominant mutation in both Europe and the US since the outbreak basically first started. It's different from the one that originally came out of China (and was responsible for the first infections in the Pacific Northwest but not most of the ones in NYC). Therefore, most of the vaccines in development in the US and Europe are dealing with this COVID mutation, so it probably won't have a big effect on vaccines. In fact, they say that convalescent plasma actually has a really strong effect of neutralizing this mutant version of virus, which is great news for vaccine development.

[+ keroscenefire]

Have they said why not? Our CDC has a live weblink, with continual updating of the numbers of hospitalizations and ICU beds used.

 

I'm not sure why they decided to not report hospitalization data. Some local health departments in Florida have been but it has not been mandated statewide. Apparently, they are going to start mandating hospitalization data now that the outbreak has gotten severe in Florida.

[Islesguy]

I'm not sure why they decided to not report hospitalization data. Some local health departments in Florida have been but it has not been mandated statewide. Apparently, they are going to start mandating hospitalization data now that the outbreak has gotten severe in Florida.

Because the governor wanted to pretend nothing was wrong so he could open the state up more and more. The most ridiculous part is there is still a mandatory quarantine for NYers who come to Florida. The outbreak is out of control there and NYers are the only ones that have to quarantine? Real smart.

[RealAvalon]

I'm not sure why they decided to not report hospitalization data. Some local health departments in Florida have been but it has not been mandated statewide. Apparently, they are going to start mandating hospitalization data now that the outbreak has gotten severe in Florida.

This is what we get. Current active COVID cases, daily and total COVID cases and deaths, break down by region, by age and sex.

https://governmentofbc.maps.arcgis.com/apps/opsdashboard/index.html#/11bd9b0303c64373b5680df29e5b5914

 

In addition there is a synopsis given on the health care system in general. Starting with the March 16th shut down, elective surgeries were canceled, and only emergency surgeries were performed. This reduced the surgical rate from about 6,000 per week down to 1,200 per week. Since the 2nd phase of re-opening May 25th the surgery rate has returned to about 6,000 surgeries per week, of which 1200 remain as emergency surgeries and 4800 as scheduled elective surgeries.

Edited July 4, 2020 by RealAvalon

[Guest]

I'm not sure why they decided to not report hospitalization data. Some local health departments in Florida have been but it has not been mandated statewide. Apparently, they are going to start mandating hospitalization data now that the outbreak has gotten severe in Florida.

If they report hospitalization data, it should be hospitalizations with the diagnosis of Covid-19, not total hospitalizations, or it's really not interpretable. Most of the patients in hospitals are not there due to Covid-19.