Coronavirus in the United States - news and thoughts

Yes, but using your chart to say that deaths currently aren't going up is dishonest. Not that hard to understand.

 

I think these guys would have us believe that all of the huge increase in covid cases are people who tested at 36-40.

 

Trying to understand the 35 v 40 argument, I'm curious if we've changed the way we label positive tests from 35 to 40?

I (sorta) understand the impact of the different results, but why is this being discussed now?

 

That is how it comes across.

But if 35 and 40 are highly correlated, then it doesn't really matter which measure we use when we are trying to see if the spread is increasing or decreasing.

Kind of like unemployment. U3 (the official number) and U6 (the scary number) are so tightly correlated that if you know the one, you effectively know the other. And when talking about unemployment rate, we are using it for making comparisons, so it doesn't really matter which one we use as long as we are consistent.

From everything I've read the cutoff of 35 and the cutoff of 40 are similar. If you cut off at 35 you will have a smaller number than if you cutoff at 40, but they are strongly correlated, and mostly used for seeing the change in rates, so it doesn't really matter which one you use for tracking. And if we have been using 40 in our tracking numbers, there isn't really a good reason for switching to 35.

 

Yes, Fauci in July said anything over 35 is almost for sure dead virus. And the link Blue posted explains things well. No reason not to release the PCR CT test results so scientists can study these millions of cases and cross reference them to hospitalizations.

 

That doesnt actually answer the question of correlation that Phil raised.

 

I question this and here is why. IF as is being discussed the PCR rate is a part of this, isn't it possible that deaths are being attributed when people have a PCR rate of 40, but covid really isn't killing them?

Not a declaration, just a question.

 

I would think depending on the time of testing that you could be catching it very early or very late. (If that is your question, it is a good one.) I also assume though a great amount of those would be people with very low viral loads that required 40 cycles to show up. Lets remember, 35 is very low as well.

 

Not at all. I am simply curious as to if that number is high. Do we have any idea? It could very well be huge as most people are fine after infection.

 

Beyond random error, which is symmetrical (i.e., known Covid deaths might not be listed as Covid and non-Covid deaths might be listed as Covid), no. Doctors are only supposed to list contributing factors to death (i.e., if I have diabetes and a gun shot wound and I died due to blood loss, it probably wasn't the diabetes so that won't get listed). Being less likely to be contagious (which is all that is really being discussed here) doesn't change the question of whether an illness contributed to death.

 

El Paso hospitals full, temp morgue trailers up to 4, expecting 6 more to store the bodies.

Texas county grapples with surge of coronavirus cases

This is what it's come to in El Paso: mobile morgues filled with a backlog of bodies. And it's not enough — there will be 10 of the trucks in the next few days.

At the Perches Funeral Home, Nena Macias showed us a room filled to capacity. They have 220 people awaiting burial or cremation, most died of COVID-19.

"They're scared. A lot of families have had a loved one pass away from COVID," Macias explained. "They're worried they may be next."


Wyoming hospitals full. sending patients out of state to get treatment

Utah institutes mask mandate

Governor declares state of emergency, mandates masks to fight COVID

Faced with more than 2,000 new daily COVID-19 cases in his state and hospitals at capacity, Utah's outgoing Gov. Gary Herbert has declared a state of emergency and issued a mandate for all residents to wear masks in public until further notice.

In addition to mandating mask-wearing, the governor laid out three other crucial elements of his emergency declaration: banning people from hosting social gatherings with individuals other than those living in their households for the next two weeks; significantly expanding the state's testing operations; and suspending all high school and club sporting events, and extracurricular activities, for the next two weeks, with the exception of playoff and championship games. Herbert said intercollegiate sports are also exempt.

 

Like I've mentioned before, I don't know enough about PCR testing to speak of 35 vs 40, but I can speak from a clinician's POV that we prefer to err on the side of extra sensitivity as opposed to specificity. We still have cases where we're sure the person has COVID but needed multiple tests to get a positive one, including a fairly young guy who's been in the ICU for a month now, as well as those who spike a fever a couple days after being admitted and end up testing positive (initial test negative). Treatment for COVID is symptom based, so a person who tests false positive whether it's because he doesn't have it at all or have so little viral load that it's inconsequential will not receive unnecessary treatment.

Frankly, how these testing thresholds affect politics is of zero concern to me. My only concern is the safety of our patients and staff, and to that end, I'd rather err on the side of higher sensitivity.

 

while we can go back and forth over what causes rise in cases, to me, it is important to look at the overall positive rate, and right now that stands at 6.5%.

 

It's a great question because it doesn't kill 220,000 healthy people. CDC website breaks it down.

 

I think that's a helpful stat, but that obviously depends on testing criteria. If testing criteria change, then the trend line for positivity rate would as well. For example, at my hospital we're starting to test all admissions. That'll increase cases and decrease positivity rate, so it'll be difficult to compare trend lines with before.

IMO, with no new treatment breakthroughs over the past few months, case fatality rate (CFR) should be stable now. Thus, I think we can go back to mortality count as a surrogate for actual prevalence of the disease. As mentioned in a previous post, I think this suggests that actual weekly growth rate is about 15%, and not the 30% of the case growth rate. Some states' hospitals are starting to get full, though, and that'll start increasing CFR so soon that might start to overestimate the prevalence.

 

question on hospitalizations, are all admissions treated the same, or do the more serious cases get placed in a special area thus making it hard to know how many hospitalizations are really critical and how many are precautionary, if say 25% are deemed critical, all admissions are recorded even if 75% are not life-threatening at the time, thus giving a worse than needed hospitalization total, maybe it needs to be recorded as critical vs non-critical.

 

I doubt you will be admitted to a hospital out of caution. There has to be a legitimate reason.

 

North Dakota requesting covid positive Healthcare workers without symptoms return to work as they have staff shortages

 

Trust me, nobody admits COVID patients unless they have to. Hospitals lose money with COVID admissions, and it's a real PITA for the staff to see COVID pts because of the donning and doffing of PPEs every time you go into the room.

 

At this point, you really wonder if there are very many people left who haven’t been exposed to the virus.