Updates on COVID 19

[Chuckanut]

I once thought the daily death count was a good indicator of current virus activity but since date of death information may be two or more month old, I no longer see how it is of any real use in helping us understand what is happening NOW.

Example: Bexar County (San Antonio) reported 26 deaths yesterday, one of the highest single day totals ever. However, many of those deaths have been "under investigation" dating back as far as early June, rendering the info meaningless as a measure of current Covid 19 activity.

The only statistic I monitor is Covid 19 hospitalizations.

Thanks for the update. For a while, I thought we might have to mount a commando style rescue mission to get the Texas members of this site to safety in Arkansas.

 

[audreyh1]

I once thought the daily death count was a good indicator of current virus activity but since date of death information may be two or more month old, I no longer see how it is of any real use in helping us understand what is happening NOW.

Example: Bexar County (San Antonio) reported 26 deaths yesterday, one of the highest single day totals ever. However, many of those deaths have been "under investigation" dating back as far as early June, rendering the info meaningless as a measure of current Covid 19 activity.

The only statistic I monitor is Covid 19 hospitalizations.

It is a long lagging indicator, that’s true. But it hasn’t started to come down yet.

Meanwhile, new cases seem to be down, but we don’t know how much of that is due to the huge drop in testing.

One unfortunate thing is that wide community spread usually means The virus is ultimately spread to the more vulnerable older and sicker populations. So we don’t know if continued high reported fatalities is due the ages of those infected rising again. Or at least I have run across those statistics.

 

[audreyh1]

One more thing she said about testing: the wait time has dropped back to 2 to 3 days from the 7 to 9 we were experiencing over the last few weeks. Tests were useless for a while there.

That is really great. I don’t know whether the folks in TX are so discouraged by testing delays that they’ve given up or what. But unless we get back to a much lower positivity rate, we are flying blind. Not to mention desperately needing fast test turnaround.

 

[JoeWras]

That is really great. I don’t know whether the folks in TX are so discouraged by testing delays that they’ve given up or what. But unless we get back to a much lower positivity rate, we are flying blind. Not to mention desperately needing fast test turnaround.

Yeah, your positivity rate is red, for sure.

In the PBS interview, our health director (Mandy Cohen) talked quite a bit about fast test turnaround. I joined the program in progress and didn't get all the details. What I did hear was NC and 6 other states are using a grant from a foundation to pool resources and come up with a fast turn around implementation. This would be the 15 minute test. It is going to take time to deploy, but should roll out this fall.

She went in detail that this fast test (antigen) is less reliable than the slow (pcr) test. However, it is important to have because it is reliable enough to give people feedback who are quite sick. The idea is the fast test will be triaged to people showing obvious symptoms of Covid. This will be important in the fall when Covid and flu overlay again. Sick people want fast feedback and will get it. Since they are sick, even if they are negative they'll be asked to isolate, and a subsequent PCR test will be ordered for them. Meanwhile, the remaining PCR tests will go for surveillance, such as mass testing in schools, jails, etc. It will also be indicated for people who only have marginal Covid symptoms.

More testing ahead. There are a lot of people working very hard on this. It is insufficient today, and recognized as such. Here's to hoping those working overtime on it come through sooner than later.

 

[REWahoo]

Meanwhile, new cases seem to be down, but we don’t know how much of that is due to the huge drop in testing.

+1

That's another reason I don't pay much attention to any local indicator other than hospitalizations. They have been steadily decreasing, but at an ever slowing rate, from a high of over 1,250 about a month ago to 710 yesterday.

 

[Montecfo]

I agree that the rate of hospitalizations is the key stat. The key problem is slow turnaround on testing. It is not very valuable if it takes more than two to three days to get the results back.

Asymptomatic folks or people with mild symptoms are less likely to test when turnaround is so slow.

Having said that, DS and his roommates all had tests recently all came back negative and it only took two days.

 

[MichaelB]

That's another reason I don't pay much attention to any local indicator other than hospitalizations. They have been steadily decreasing, but at an ever slowing rate, from a high of over 1,250 about a month ago to 710 yesterday.

I track cases, hospitalizations and deaths, but agree hospitalizations can be a more meaningful trend number. That’s not good news for Florida. While there are still some issues with reporting, hospitalizations are running at 3x the rate on June 1 and 2x the rate of July 1. It’s persistent and the 7 day average is still trending up, now at 480 per day. Not as high as the rate in Texas, but still enough to challenge the system. The high ratio of fatalities to hospitalizations is also worrisome.

 

[Sunset]

What happens when a hospital is full. It seems like their hospitalization rate falls to zero, and then as space becomes available, they admit 1, or 2, or 3 people per day. Still a hospitalization rate that is very good.

Seems with any number there are issues.

 

[timo2]

NY Times graphic version of CDC Excess Deaths.
"Across the United States, at least 200,000 more people have died than usual since March, according to a New York Times analysis of estimates from the Centers for Disease Control and Prevention. This is about 60,000 higher than the number of deaths that have been directly linked to the coronavirus."

Counting deaths takes time and many states are weeks or months behind in reporting. The estimates from the C.D.C. are adjusted based on how mortality data has lagged in previous years. Even with this adjustment, it’s possible there could be an underestimate of the complete death toll if increased mortality is causing states to lag more than they have in the past or if states have changed their reporting systems.

But comparing recent totals of deaths from all causes can provide a more complete picture of the pandemic’s impact than tracking only deaths of people with confirmed diagnoses.

https://www.nytimes.com/interactive...oEZ7zXbM9PzUar9xm9tfcwL_dEtpEfC0uU_16SOET5nT0

 

[cathy63]

California has caught up with the backlog of data that had accumulated due to failure to renew a certificate (SSL cert I guess?) and the inability of the state's infectious disease reporting system to handle the pandemic-sized volume of data.

https://deadline.com/2020/08/califo...met-lowest-daily-total-in-7-weeks-1203013673/

Newsom said the state has been through the roughly 295,000 backlogged cases and that there were “roughly 20,000 positives in that cohort.”

https://update.covid19.ca.gov/

Even with the 20K additional cases reported this week, the overall new cases trend is downward, with test positivity just over 6%. Hospitalizations are also down 25% in the past three weeks. Unfortunately, the death rate is continuing to climb. I hope we are reaching the peak for that as well.

 

[audreyh1]

California has caught up with the backlog of data that had accumulated due to failure to renew a certificate (SSL cert I guess?) and the inability of the state's infectious disease reporting system to handle the pandemic-sized volume of data.

Even with the 20K additional cases reported this week, the overall new cases trend is downward, with test positivity just over 6%. Hospitalizations are also down 25% in the past three weeks. Unfortunately, the death rate is continuing to climb. I hope we are reaching the peak for that as well.

That’s a pretty decent positivity rate, and looks really good compared to Texas and Georgia.

I have a concern that we may see higher death rates for a while (unfortunately GA seems to be on a roll!), because wide community spread inevitably leads to nursing homes and other vulnerable populations, in spite of all the protections, and in some areas the protections are inadequate.

After declining, Covid-19 cases are rising again in US nursing homes

Wright's mother, who has Alzheimer's, is on the leading edge of worrisome national trend: Confirmed Covid-19 cases in US nursing homes are rising rapidly again after a steady decline in June.

The American Health Care Association and National Center for Assisted Living (AHCA/NCAL), which released a report this week highlighting the steep increase in cases, said it's no surprise.
....
The uptick in nursing home cases tracks with the soaring number of infections among the general population in late June and July, according to the AHCA/NCAL report. Florida and Arizona, along with Texas and California, have topped the list of states with the highest growth in infections in recent weeks. Lack of rapid testing and an inadequate supply of personal protective equipment (PPE) is compounding the problem.

"As the CMS data shows, the increase in new cases in nursing homes is being driven by the spike in cases in the surrounding communities and exacerbated by shortages in PPE and the significant delay [up to five days or longer] in obtaining test results for nursing home staff and residents," said Parkinson. .

https://www.cnn.com/2020/08/14/health/nursing-home-rise-in-covid-wellness/index.html

 

[audreyh1]

Georgia not doing so good overall.

Georgia has the highest seven-day average of new cases per 100,000 people with 31.99, according to Johns Hopkins University.

https://www.cnn.com/2020/08/14/us/report-white-house-georgia-mask-mandate/index.html

Also highest death toll on Tuesday.

Oh man, I just noticed that our small GA county was at the top of the list today for highest number of cases per 100,000 over the past 7 days for the entire state, according to NY times.

 

[cathy63]

That’s a pretty decent positivity rate, and looks really good compared to Texas and Georgia.

I have a concern that we may see higher death rates for a while, because wide community spread inevitably leads to nursing homes and other vulnerable populations, in spite of all the protections, and in some areas the protections are inadequate.

Yeah, statewide we have had good test positivity numbers for a while, with the 14-day average below 8% since early May. Things have been much worse in some counties though. The high percentages from the rural counties are just overwhelmed by the large total counts from L.A, San Diego, San Jose and Oakland, so any statewide number for CA is really just about the cities. We do still have big problems in the Central Valley farming communities -- high density housing and itinerant workers are a really bad combination for Covid spreading.

Nursing home deaths as a percentage of overall deaths have been dropping for a while in CA. Back in May/June we had a horrifying 52% of deaths from Nursing Homes, and now it's down to 42%, so while still awful it's not nearly as bad as it was.

 

[audreyh1]

More on “Sun-belt” nursing home recent increase in cases.

Nursing homes in the Sun Belt had months to prepare for rising coronavirus cases. They still weren’t ready.

In Texas, the seven-day average of new nursing home cases nearly tripled in July, from 148 per day to 413 as of Aug. 6. By the beginning of August, 60 percent of all Texas nursing homes had at least one active coronavirus-positive case among staffers or residents. Both those figures have since declined somewhat as cases have plateaued but are still well above earlier levels.

The number of Florida residents living in nursing homes and assisted-living facilities testing positive doubled between July 7 and July 27 and has remained steady since. The seven-day average of new cases in California nursing homes has risen nearly 40 percent since the first week of July.
....
In California, Texas, Oklahoma, Arizona and Florida, cases rose rapidly this summer among young adults. And health officials say that once community spread has taken hold, it is only a matter of time before the virus finds its way into nursing homes. That is true even as total cases in these states have started to recede.

“When there’s high community spread, the odds are not in your favor,” said Greg Shelley, program manager of the Harris County, Tex., Long-term Care Ombudsman Program, which is at the Cizik School of Nursing at UTHealth.

“And once it gets in, it can be difficult to contain,” said Kristen Knapp, a spokeswoman for the Florida Health Care Association, which represents for-profit nursing homes.

https://www.washingtonpost.com/business/2020/08/14/nursing-homes-lessons-learned/ Paywall but you might be able to access through private window. I read via Apple News app.

 

[GravitySucks]

NY positivity rate is the lowest yet - 0.71%

DGF and I are going to the Fingerlakes and visit a couple wineries. Can think life will soon get much safer than this.

 

[audreyh1]

NY positivity rate is the lowest yet - 0.71%

DGF and I are going to the Fingerlakes and visit a couple wineries. Can think life will soon get much safer than this.

Wow, that’s great! With that much testing localized outbreaks should be detected quickly before they get much larger.

 

[audreyh1]

OK - finally the sudden drop to low test numbers and high positivity rate issue has been resolved and Texas is back to a positivity rate of around 13% after jumping above 24% a week prior. Around Aug 13 or 14 there were over 124,000 tests reported, of which 95,000 were a backlog from labs. Looks like there was another spike on August 16 of over 117,000 tests, so maybe that was another catch-up day. Florida has also had some recent backlogged tests reported.
https://www.texastribune.org/2020/08/14/texas-coronavirus-testing-dshs/

 

[rodi]

Hyper local news. 2 items.

1) San Diego county was removed from the state watch list. If we continue with low numbers local schools will have the option to reopen in person learning.

2) Son was sent home from work this morning after flunking the temp check (very low grade fever). Arranged for and took him for a covid test this morning since work is still deciding (and hasn't notified him) if he needs a negative test to return to work. We are now wearing masks when in the same room as him, banned other son's girlfriend from masked visits and other son from visiting said girlfriend (they are bummed).

The good news is the test was readily available - 1 day wait for appointment through the county, but no wait through our insurance (Kaiser Permanente). Results supposed to be back in 48-72 hours.

 

[Lsbcal]

Hyper local news. 2 items.

1) San Diego county was removed from the state watch list. If we continue with low numbers local schools will have the option to reopen in person learning.

2) Son was sent home from work this morning after flunking the temp check (very low grade fever). Arranged for and took him for a covid test this morning since work is still deciding (and hasn't notified him) if he needs a negative test to return to work. We are now wearing masks when in the same room as him, banned other son's girlfriend from masked visits and other son from visiting said girlfriend (they are bummed).

The good news is the test was readily available - 1 day wait for appointment through the county, but no wait through our insurance (Kaiser Permanente). Results supposed to be back in 48-72 hours.

Our son was tested in early August in San Diego since he was driving up to visit us. It took 8 days to get the results. Hopefully your son's test will be faster.

 

[Dtail]

Florida's daily cases finally decreasing. Still #2 in cases per 1m and #15 in deaths per 1m.

 

[Chuckanut]

Supposedly, all counties in Washington state have dropped to slightly below 1.0 in terms of the transmission rate.

Note: this is different from rt.live. I have no idea why. Maybe I am comparing apples to oranges?

What I do see is lots of people masking up even when outside in relatively uncrowded situations where prolonged exposure at less than 6 feet (Even less than 12 feet) would required a conscious effort on the part of an individual. So maybe people are taking this seriously again.

 

[audreyh1]

Supposedly, all counties in Washington state have dropped to slightly below 1.0 in terms of the transmission rate.

Note: this is different from rt.live. I have no idea why. Maybe I am comparing apples to oranges?

What I do see is lots of people masking up even when outside in relatively uncrowded situations where prolonged exposure at less than 6 feet (Even less than 12 feet) would required a conscious effort on the part of an individual. So maybe people are taking this seriously again.

Should be the same thing I think, but perhaps estimated a different way? Does rt.live give values for counties?

Oh I hope people are taking this seriously again!

 

[Chuckanut]

Should be the same thing I think, but perhaps estimated a different way? Does rt.live give values for counties?

Oh I hope people are taking this seriously again!

Well another station reports some counties are now spiking!!! This morning we were on our way to getting a handle on this thing and now we have issues. I'll just keep doing what I need to do to protect me and mine.

 

[rodi]

What I do see is lots of people masking up even when outside in relatively uncrowded situations where prolonged exposure at less than 6 feet (Even less than 12 feet) would required a conscious effort on the part of an individual. So maybe people are taking this seriously again.

Maybe these people are like me.... I mask up when I see the first person at the start of my walk and keep it on for my entire walk. I figure it's more efficient and less touching of the face to just keep the mask on rather than taking it on and off. (Although I sometimes drop it to my chin if I have a long stretch with no other pedestrians around.)

 

[Koolau]

Though HI numbers are (IMHO) still quite low (a bit over 5000 positives and IIRC fewer than 40 deaths - Total pop. 1.4 mil) we have had a SHARP increase in positives of late. From 10 to 15 per day to a couple of hundred per day (for quite a while now.) Bad times are ahead, I fear - but that's another story.

With this as background, I was quite stunned to see a report in the local paper, breaking down our ethnic background vs cases. I believe that HI is one of the few states which keeps such detailed and accurate records on ethnicity (actually, it's more of a "where did you or your ancestors originally come from in the world" as well as "ethnicity.") ONE group which represents 4% of the population accounted for 24% of the cases (IIRC). Most other groups (8 or 10 groups as I recall) were well within what I would have expected (perhaps a 10% group got 8% of cases and a 12% group got 15% of cases, etc.)

I don't know if the study is available on line at Honolulu Star Advertiser, but I was quite surprised. I won't mention the group because I don't believe it is instructive to us laymen. Still, there must be some valuable insight available to our professionals from this data. YMMV