Testing and new cases: ~584k tests yesterday, ~22.5 million total. There were about ~23.7k positives with percentage positive at 4%. Testing is not as high as it seems. TN and VA dumped a huge backlog of tests into the system today. Still a high volume day but actually under 500k when you remove the backlog.
Hospitalizations decreasing at 3.0% per day. Best metric. However, review the problems. I rephrased some of these compared with yesterday’s to be more accurate:
1. All hospitalizations are rising as demand for routine procedures rises and will eventually exceed normal given delayed care during the last 3 months.
2. Most patients who grace the door of most hospitals are tested (in the several states I have researched). Some will be positive. This is not a hospitalization due to CV19 but it's counted as such. I’m speaking of inpatients, not elective cases that are sent home.
3. "Hoteling" is occurring where patients are staying longer awaiting negative CV19 testing before they can go to a rehab or long-term care facility.
4. There are still hospitalizations that are real. That’s not the point of these statements. However, perspective and context are necessary to get the real picture. Blaming protests or Memorial Day gatherings is lazy. Timing is the worst data corollary in scientific research. Coincidence is not cause and effect. Outdoor gatherings are 10-100x less likely to spread the virus. That’s a factual statement. Think about spring break in FL… nothing. Beaches re-opened… nothing. Georgia has been open now for several weeks… looks good. But let’s be clear. I’m not saying real cases aren’t there or even that they aren’t rising in some areas.
Total deaths at 108,554 per covidtracking. Weekly deaths as below by week (row), and day (column) starting with Sunday with a weekly total at the end and percent fall compared with prior week.
751 deaths today. More backlog out of GA today, just a little.
0979--> 0837--> 1510--> 1726--> 1741--> 1654--> 1286 = 9733 (-15%)*
0839--> 0786--> 1430--> 1402--> 1513--> 1261--> 1105 = 8336 (-14%)
0654--> 0523--> 0629--> 1259--> 1353--> 1186--> 0989 = 6593 (-21%)
0656--> 0469--> 1051*--> 995--> 0909--> 0749*--> 0746 = 5575 (-15%)
0453--> 0462*--> 941 --> 889--> 0898--> 0751
New York. Cases ~820 today with 72.4k tests, ~1.1%+. Most of NY cases are now false positives as that rate is 1% of all tests (724 today).
Hospitalizations 2,344--> 2190--> 2042--> 1898 (-20%).
Deaths 54 today, trend:
57--> 54--> 64--> 56--> 54--> 42--> 37
47--> 40--> 49--> 56--> 38--> 54
New Jersey. 46 Deaths. ~51.2% of deaths are in nursing homes, 87% today.
64--> 23--> 49--> 110--> 90--> 79--> 57
70--> 38--> 89--> 074--> 66--> 46
Hosp: 1933--> 1933--> 1882--> 1740--> 1736--> 1701--> 1512-->1480 (-24%)
Illinois. 78 Deaths. 54.8% of deaths are in NH's, 84.7% in the weekly update today.
Hosp: 3044--> 2911--> 2702--> 2550--> 2496--> 2458--> 2365--> 2209 (-28%)
MI/MA/PA. 5, 46, 49 deaths, respectively.
Florida. 29 deaths. 52.6% of deaths in NH's, 86.2% today. 6.5%+ today.
Headlines are scary here. My goodness. A lot of cases... ok. Look at the percent positive. It's still low. I don't have hospitalization data for Florida but docs in Pensacola say things are ok there. I see nothing to worry about yet.
Georgia. 43 deaths. 46.6% of deaths in NH's. 6.3% + testing last 7 days, see below.
Hospitalizations 790--> 788--> 783--> 819--> 834--> 817--> 842--> 836 (+5.8%)
Louisiana. 9 deaths. 41.8% of total deaths are in NH's.
Hospitalizations 613--> 604--> 582--> 575--> 582--> 568--> 553--> 549 (-11%)
MS. 13 deaths. 51.4% of deaths in NH's. 46.2% today.
608 cases over 2 days. We learned from Dr. Dobbs today that MS is testing Native American's aggressively it appears and they are about 8x more likely to get CV19 vs the rest of MS. Notice a trend here? Same in Arizona and New Mexico. However, I cannot find the data to which he is referring and he gave no source.
Hospitalizations: 442--> 409--> 408--> 358--> 390--> 443--> 434--> 486 (+10%)
I know UMMC is busy, confirmed. St. D in Jackson, low to moderate it appears. I know Forest General is moderate and stable. Sounds like the delta is busy as well. Tupelo is busy. We are low and stable on the coast. Clearly there are pockets of localized outbreaks in MS. Virus is making its way through the state slowly but surely. When you see UMMC less busy, that will be a great sign but it will be last to get there. If you, a spouse or good friend have knowledge of local hospital data please DM me. Good or bad, I want to know. The graph below is good news:
CLI is still a very small percentage of ER visits.
Alabama. 865 cases, 14 deaths. 51.3% of deaths in NH's.
Hospitalizations 614--> 611--> 594--> 600--> 600--> 629--> 647--> 622.
Mobile county with 32, Baldwin 7, Montgomery 82, Tuscaloosa 71, and Jefferson 87.
Texas. Deaths 23. 46.3% of deaths in NH's.
Hospitalizations: 1822--> 1878--> 1935--> 2056--> 2153--> 2008--> 2166 (+18%)
Some data regarding Houston… what’s happening there? Lots to go through...
Houston isn't even where it was back in April in regard to ICU beds. They shuttered the field hospital on 4/24, now it's about the same and they are on the "precipice of disaster"? Also, The ratio is all off now compared to that prior high point with fewer ICU beds per admit for CV19. That's odd. Several possibilities. Like we've pointed out, some of this is "hoteling" and admits for other reasons that test positive. Another possibility is that many of these are all real and the virus is less virulent requiring less ICU care. TX does use HCQ so less sick because of that? Maybe a combo of all four? Regardless, that's a pretty encouraging graphic.
Now for TMC (Texas Medical Center Hospital System):
Definitely a trend up but nothing crazy. Currently back to April levels. I like this hospital level data. The more specific you can be the better. Also, note the trend up in the 7 day average started on 5/18, a week BEFORE Memorial Day. Facts... pesky little things. This hospital system has 14% of ICU beds occupied by CV19 patients. Its run 10-16% since early April. Its higher than the state as a whole which is ~8% currently of ICU beds. One last graph for Texas:
Sooooo... yeah... what spike/surge are we talking about again? Idiots, liars or both.
CA. 62 deaths. 50.2% of all deaths in NH's. 5.4% + testing.
Hospitalizations 4625--> 4526--> 4525--> 4506--> 4583--> 4776--> 4534--> 4480 (-3.2%)
7% of all cases in CA are under age 18.
Anyone notice the trend here? It's actually slightly downward.
Arkansas. 5 deaths. 731 cases. A new record... but...
Hospitalizations 147--> 154-->145--> 171--> 173--> 181--> 187--> 203 (+38%)
This trend is concerning but again, not crazy. Needs watching.
As for the record number of cases, it seems really scary until you know this... 207 are from correctional facilities. The other 524 are from nursing homes and the general population, including 199 cases from Tyson’s facility in Springdale of which 1 was symptomatic. That is a 99.5% asymptomatic rate in a poultry plant.
Tennessee. Deaths 27. Dumped a huge number of negatives into the system today of almost 50k that are old. That is good. It was already very low %-wise in TN anyway, this makes it even lower at right around 5% total.
South Carolina. 5 deaths. 46.2% of deaths in NH's. 729 cases. SC has been 4-6%+ for three weeks. Its actually even lower... see below.
Hosp: 450--> 453--> 477--> 507--> 541--> 513--> 494--> 512 (+13.7)
SC has been naughty. Very naughty. I learned today that despite 23,000 cases in the state a lot are duplicates. SC reports all positive tests, not positive persons. Guess how many are repeat positives on the same patient? 500? 1000? 2500? 5000? Nope, nyet, no and nah.... try 6000! That means SC has only 17000 positive persons. Think that matters much? SC isn't the only state that does this either. Many of them do. When large states do it, looking at you California, it can have a tremendous impact on the "new cases."
North Carolina. 28 deaths. 60.3% of deaths in NH's. 7% + testing. This has been flat with 7 day average ~8% for two weeks.
Hosp: 717--> 708--> 696--> 739--> 774--> 780--> 812--> 760 (+6%)
Very slow trend up in NC. This is a real trend IMO because CLI tracking data shows just under 3% of ER visits are still for Covid-like illness. That's the highest I have seen. It's a low-moderate level. Most states are <2%. Let's put the hospitalizations in perspective... there are 23,000 beds in the state and they have 72% of vent capacity available.
Arizona. 17 deaths today. There was 1, yes one, new admission in AZ today. AZ also counts positive tests instead of person positives.
Hosp: 1278-->1266--> 1243--> 1274--> 1266--> 1274--> 1291--> 1336 (+4.5%)
Comments:
1. There will be no post tomorrow. This one was a lot of work. I need a break. I'll do a combined post Sunday of the weekend.
2. Lockdowns kill. From the article: "Overdoses claimed more lives in May than COVID-19 has claimed all year in province."
3. Dr. Muge Cevik has been a great voice in the pandemic. I don't agree with all of her conclusions but she is reasoned and data driven. She critiques the recent "study" in the Annals of Internal Medicine by Topol, et.al., in which they concluded that asymptomatic transmission drives half of the infections. Nothing in the paper even comes close to supporting this claim. She calls it an opinion piece... yes, yes it was. Thank you Dr. Cevik. We need fewer opinions and more data driven analysis. What passes for science these days is appalling.
4. Lockdowns kill part 2: https://pagetwo.completecolorado.com/2020/06/11/dierenbach-the-coronavirus-response-has-been-deadly/
"...there is also reason to believe many of the excess deaths that have occurred over the last couple of months were not caused by coronavirus, but by our response to coronavirus."
5. Incompetence in NY killed a lot of people. Article here behind paywall @WSJ. Summary here.
6. Ireland says no more lockdowns. France, Denmark, Belgium and Norway have said the same. https://www.independent.ie/irish-ne...-is-hit-by-second-wave-of-virus-39271031.html
7. Nice review paper. Pre-symptomatic patients only responsible for transmitting 6.4% of cases by contact tracing. This is direct contact tracing analysis. That's how you figure this out. Not models or other bullsh!t theoretical garbage like Dr. Cevik had to rebuke. Contact tracing studies are the gold-standard here. They also review a study that gives asymptomatic patients an R0 of <0.1. Yeah, that's spreading it around all right. So what's the utility of masks if you aren't ill?
https://www.archivesofpathology.org/doi/pdf/10.5858/arpa.2020-0255-LE
8. Finally, lockdowns kill.
Cheers RGers
Hospitalizations decreasing at 3.0% per day. Best metric. However, review the problems. I rephrased some of these compared with yesterday’s to be more accurate:
1. All hospitalizations are rising as demand for routine procedures rises and will eventually exceed normal given delayed care during the last 3 months.
2. Most patients who grace the door of most hospitals are tested (in the several states I have researched). Some will be positive. This is not a hospitalization due to CV19 but it's counted as such. I’m speaking of inpatients, not elective cases that are sent home.
3. "Hoteling" is occurring where patients are staying longer awaiting negative CV19 testing before they can go to a rehab or long-term care facility.
4. There are still hospitalizations that are real. That’s not the point of these statements. However, perspective and context are necessary to get the real picture. Blaming protests or Memorial Day gatherings is lazy. Timing is the worst data corollary in scientific research. Coincidence is not cause and effect. Outdoor gatherings are 10-100x less likely to spread the virus. That’s a factual statement. Think about spring break in FL… nothing. Beaches re-opened… nothing. Georgia has been open now for several weeks… looks good. But let’s be clear. I’m not saying real cases aren’t there or even that they aren’t rising in some areas.
Total deaths at 108,554 per covidtracking. Weekly deaths as below by week (row), and day (column) starting with Sunday with a weekly total at the end and percent fall compared with prior week.
751 deaths today. More backlog out of GA today, just a little.
0979--> 0837--> 1510--> 1726--> 1741--> 1654--> 1286 = 9733 (-15%)*
0839--> 0786--> 1430--> 1402--> 1513--> 1261--> 1105 = 8336 (-14%)
0654--> 0523--> 0629--> 1259--> 1353--> 1186--> 0989 = 6593 (-21%)
0656--> 0469--> 1051*--> 995--> 0909--> 0749*--> 0746 = 5575 (-15%)
0453--> 0462*--> 941 --> 889--> 0898--> 0751
New York. Cases ~820 today with 72.4k tests, ~1.1%+. Most of NY cases are now false positives as that rate is 1% of all tests (724 today).
Hospitalizations 2,344--> 2190--> 2042--> 1898 (-20%).
Deaths 54 today, trend:
57--> 54--> 64--> 56--> 54--> 42--> 37
47--> 40--> 49--> 56--> 38--> 54
New Jersey. 46 Deaths. ~51.2% of deaths are in nursing homes, 87% today.
64--> 23--> 49--> 110--> 90--> 79--> 57
70--> 38--> 89--> 074--> 66--> 46
Hosp: 1933--> 1933--> 1882--> 1740--> 1736--> 1701--> 1512-->1480 (-24%)
Illinois. 78 Deaths. 54.8% of deaths are in NH's, 84.7% in the weekly update today.
Hosp: 3044--> 2911--> 2702--> 2550--> 2496--> 2458--> 2365--> 2209 (-28%)
MI/MA/PA. 5, 46, 49 deaths, respectively.
Florida. 29 deaths. 52.6% of deaths in NH's, 86.2% today. 6.5%+ today.
Headlines are scary here. My goodness. A lot of cases... ok. Look at the percent positive. It's still low. I don't have hospitalization data for Florida but docs in Pensacola say things are ok there. I see nothing to worry about yet.
Georgia. 43 deaths. 46.6% of deaths in NH's. 6.3% + testing last 7 days, see below.
Hospitalizations 790--> 788--> 783--> 819--> 834--> 817--> 842--> 836 (+5.8%)
Louisiana. 9 deaths. 41.8% of total deaths are in NH's.
Hospitalizations 613--> 604--> 582--> 575--> 582--> 568--> 553--> 549 (-11%)
MS. 13 deaths. 51.4% of deaths in NH's. 46.2% today.
608 cases over 2 days. We learned from Dr. Dobbs today that MS is testing Native American's aggressively it appears and they are about 8x more likely to get CV19 vs the rest of MS. Notice a trend here? Same in Arizona and New Mexico. However, I cannot find the data to which he is referring and he gave no source.
Hospitalizations: 442--> 409--> 408--> 358--> 390--> 443--> 434--> 486 (+10%)
I know UMMC is busy, confirmed. St. D in Jackson, low to moderate it appears. I know Forest General is moderate and stable. Sounds like the delta is busy as well. Tupelo is busy. We are low and stable on the coast. Clearly there are pockets of localized outbreaks in MS. Virus is making its way through the state slowly but surely. When you see UMMC less busy, that will be a great sign but it will be last to get there. If you, a spouse or good friend have knowledge of local hospital data please DM me. Good or bad, I want to know. The graph below is good news:
CLI is still a very small percentage of ER visits.
Alabama. 865 cases, 14 deaths. 51.3% of deaths in NH's.
Hospitalizations 614--> 611--> 594--> 600--> 600--> 629--> 647--> 622.
Mobile county with 32, Baldwin 7, Montgomery 82, Tuscaloosa 71, and Jefferson 87.
Texas. Deaths 23. 46.3% of deaths in NH's.
Hospitalizations: 1822--> 1878--> 1935--> 2056--> 2153--> 2008--> 2166 (+18%)
Some data regarding Houston… what’s happening there? Lots to go through...
Houston isn't even where it was back in April in regard to ICU beds. They shuttered the field hospital on 4/24, now it's about the same and they are on the "precipice of disaster"? Also, The ratio is all off now compared to that prior high point with fewer ICU beds per admit for CV19. That's odd. Several possibilities. Like we've pointed out, some of this is "hoteling" and admits for other reasons that test positive. Another possibility is that many of these are all real and the virus is less virulent requiring less ICU care. TX does use HCQ so less sick because of that? Maybe a combo of all four? Regardless, that's a pretty encouraging graphic.
Now for TMC (Texas Medical Center Hospital System):
Definitely a trend up but nothing crazy. Currently back to April levels. I like this hospital level data. The more specific you can be the better. Also, note the trend up in the 7 day average started on 5/18, a week BEFORE Memorial Day. Facts... pesky little things. This hospital system has 14% of ICU beds occupied by CV19 patients. Its run 10-16% since early April. Its higher than the state as a whole which is ~8% currently of ICU beds. One last graph for Texas:
Sooooo... yeah... what spike/surge are we talking about again? Idiots, liars or both.
CA. 62 deaths. 50.2% of all deaths in NH's. 5.4% + testing.
Hospitalizations 4625--> 4526--> 4525--> 4506--> 4583--> 4776--> 4534--> 4480 (-3.2%)
7% of all cases in CA are under age 18.
Anyone notice the trend here? It's actually slightly downward.
Arkansas. 5 deaths. 731 cases. A new record... but...
Hospitalizations 147--> 154-->145--> 171--> 173--> 181--> 187--> 203 (+38%)
This trend is concerning but again, not crazy. Needs watching.
As for the record number of cases, it seems really scary until you know this... 207 are from correctional facilities. The other 524 are from nursing homes and the general population, including 199 cases from Tyson’s facility in Springdale of which 1 was symptomatic. That is a 99.5% asymptomatic rate in a poultry plant.
Tennessee. Deaths 27. Dumped a huge number of negatives into the system today of almost 50k that are old. That is good. It was already very low %-wise in TN anyway, this makes it even lower at right around 5% total.
South Carolina. 5 deaths. 46.2% of deaths in NH's. 729 cases. SC has been 4-6%+ for three weeks. Its actually even lower... see below.
Hosp: 450--> 453--> 477--> 507--> 541--> 513--> 494--> 512 (+13.7)
SC has been naughty. Very naughty. I learned today that despite 23,000 cases in the state a lot are duplicates. SC reports all positive tests, not positive persons. Guess how many are repeat positives on the same patient? 500? 1000? 2500? 5000? Nope, nyet, no and nah.... try 6000! That means SC has only 17000 positive persons. Think that matters much? SC isn't the only state that does this either. Many of them do. When large states do it, looking at you California, it can have a tremendous impact on the "new cases."
North Carolina. 28 deaths. 60.3% of deaths in NH's. 7% + testing. This has been flat with 7 day average ~8% for two weeks.
Hosp: 717--> 708--> 696--> 739--> 774--> 780--> 812--> 760 (+6%)
Very slow trend up in NC. This is a real trend IMO because CLI tracking data shows just under 3% of ER visits are still for Covid-like illness. That's the highest I have seen. It's a low-moderate level. Most states are <2%. Let's put the hospitalizations in perspective... there are 23,000 beds in the state and they have 72% of vent capacity available.
Arizona. 17 deaths today. There was 1, yes one, new admission in AZ today. AZ also counts positive tests instead of person positives.
Hosp: 1278-->1266--> 1243--> 1274--> 1266--> 1274--> 1291--> 1336 (+4.5%)
Comments:
1. There will be no post tomorrow. This one was a lot of work. I need a break. I'll do a combined post Sunday of the weekend.
2. Lockdowns kill. From the article: "Overdoses claimed more lives in May than COVID-19 has claimed all year in province."
3. Dr. Muge Cevik has been a great voice in the pandemic. I don't agree with all of her conclusions but she is reasoned and data driven. She critiques the recent "study" in the Annals of Internal Medicine by Topol, et.al., in which they concluded that asymptomatic transmission drives half of the infections. Nothing in the paper even comes close to supporting this claim. She calls it an opinion piece... yes, yes it was. Thank you Dr. Cevik. We need fewer opinions and more data driven analysis. What passes for science these days is appalling.
4. Lockdowns kill part 2: https://pagetwo.completecolorado.com/2020/06/11/dierenbach-the-coronavirus-response-has-been-deadly/
"...there is also reason to believe many of the excess deaths that have occurred over the last couple of months were not caused by coronavirus, but by our response to coronavirus."
5. Incompetence in NY killed a lot of people. Article here behind paywall @WSJ. Summary here.
6. Ireland says no more lockdowns. France, Denmark, Belgium and Norway have said the same. https://www.independent.ie/irish-ne...-is-hit-by-second-wave-of-virus-39271031.html
7. Nice review paper. Pre-symptomatic patients only responsible for transmitting 6.4% of cases by contact tracing. This is direct contact tracing analysis. That's how you figure this out. Not models or other bullsh!t theoretical garbage like Dr. Cevik had to rebuke. Contact tracing studies are the gold-standard here. They also review a study that gives asymptomatic patients an R0 of <0.1. Yeah, that's spreading it around all right. So what's the utility of masks if you aren't ill?
https://www.archivesofpathology.org/doi/pdf/10.5858/arpa.2020-0255-LE
8. Finally, lockdowns kill.
Cheers RGers
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