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Covid19 6/29 update

drmikecmd

4-Year Starter
Gold Member
Jan 7, 2016
3,341
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Testing Data
~569k
tests yesterday,
~31.5 million total tests performed to date.
~36.5k positives with percentage positive at 6.4%.
Nice to see the cases come down but probably just some weekend effect. That being said, TN cleared a lot of backlog today with nearly 30k tests and 2100 positives so that actually made the number higher than it would normally be. They did the same on Friday and skipped yesterday. Another point on testing we need to be very cognizant of is lack of reporting negatives. Over the last few days I've been trying to determine which states do not report all negative testing. I don't care about small numbers but large numbers make a big difference obviously. I did find out that GA uses the same company as NC and that company only reports positive testing to the state. Locally, Ingalls and Chevron only report positives to the state, not negatives. Most businesses that are mass testing employees are only reporting positives. Where is this occurring? Re-opening states... GA, FL, TX, MS, AL, TN, AZ, CA. The data is heavily salted of late... more than usual. This is falsely elevating the positive percentage. I'm giving this salting another week or so... I believe we trend back down at the end of the week. Just a gut feeling.

Hospitalization Data
Hosp. 28490 ---> 29920--> 30826--> 31532--> 31423--> 32220--> 32117--> 33198 (+16.5%)
ICU.... 5311-----> 5416----> 5279---> 5305---> 5263----> 5296----> 5230--> 5363 (+1%)
Vent... 2299-----> 2293----> 2248---> 2214---> 2075----> 2159----> 2077--> 2011 (-13%)
Hospitalizations are up as are ICU today. But vents continue to fall. This divergence is striking so far. Could be that vents will trend up just behind the ICU numbers... I don't know but the acuity and severity of this illness has waned tremendously according to these numbers. 44% of ICU patients of 25 states reporting are in AZ and CA. Texas does report it and I give you those numbers but it isn't on their dashboard so CTP misses it. I've thought about adding it into the totals everyday but it's too much work and I find it better to track separately.

Fatality Data
Total deaths at 119,761 per CTP. 54% of all deaths are in NH's. 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. 332 deaths today.

656--> 469--> 1051*--> 995--> 0909--> 0749*--> 0746 = 5575 (-15%)
453--> 462--> 0941---> 889--> 0898--> 0751 --> 0695 = 5089 (-9%)
358--> 375--> 0713---> 782--> 0795--> 0648 --> 0630 = 4301 (-16%)
297--> 285--> 0703---> 722--> 0646--> 0619--> 0506 = 3778 (-12%)
273--> 332


This little bump today vs last week is not real. I told you PA hadn't updated in 3 days. MS also added in 18 legacy deaths today and RI did as well as they had not updated in several days. You know the numbers have become small when MS and RI reporting can mess up the trends. Adjusting for those three states, we are still at last week's number (remove 18, 15 and 10 = 289).

State Data
Texas. Deaths 27. 44.3% of deaths in NH's.
Hos: 3711--> 4092--> 4389--> 4739--> 5102--> 5423--> 5497--> 5913 (+59%)
ICU: 1143--> 1220--> 1325--> 1399--> 1460--> 1727--->1684--> **** (+*%)
The best data point I have on Texas today is ILI and CLI monitoring. That is those presenting with symptoms consistent with influenza or CV19. It has fallen 4 straight days... a lot. Can't believe I missed that yesterday. This data is not weekend updated. If that continues with the more recent update it would be very good. My site for ICU data wasn't updated today when I posted.

Houston area:
Things are slowing down here:

Look at the light blue lines I added on the ICU data. Which hill would you rather walk up? The most recent one on the far right, correct? The rise is slowing... Also, look at the numbers I've circled on the hospital line (green line). In the Houston TSA, hospitalizations have not changed in a month.
How about TMC specifically:

So, again, what's the concern? That ICU beds are at 95% capacity? Hospitals run like that all of the time with rare exception. Another thing, don't look now but the % of ICU beds occupied by CV19 is dropping.

Dallas area: Remains solid. 21% of ICU beds available. My ID/epi friend in Dallas is fit to be tied over what's happening in this state. At least she's speaking up...

San Antonio... They still have 20% of ICU beds and 68% of vent capacity available and those are stable. ICU admits remain flat. Still watching...

Austin area... 19% of ICU capacity and 72% of vent capacity remaining. 343 patients... in a city of one million.

Need more evidence Texas is fine? Lindsey Rosales, a spokeswoman for the Texas Department of State Health Services, confirmed this week that the state is categorizing every inpatient in the state with a positive COVID-19 test as a COVID-19 hospitalization. The number of hospitalizations are "being misinterpreted," said Houston Methodist CEO Marc Boom, "and, quite frankly, we’re concerned that there is a level of alarm in the community that is unwarranted right now."

It is now estimated that half of Texas CV19 hospitalizations are there for something else entirely.

Florida. 28 deaths. 52.8% of deaths in NH's.
New admits based on cumulative hospital admissions:
69--> 74--> 192--> 186--> 189--> 200--> 165
98--> 82--> 207--> 249--> 203--> 213--> 151
108--> 111
5300 cases today on close to 40k tests. I'm not buying anything anyone is selling on Florida and you shouldn't either. This state looks great. A full 34% of hospitalized CV19 patients are not in the hospital for CV19. Cases have been trending up for a month now. Deaths haven't done anything but continue to fall even in the older population:

Do you understand what you are looking at? That is a graph of 60 and over patient cases and deaths. Despite the massive runup in cases of the older population, deaths in the same population continue to fall. If you do this plot with 75+ year olds it looks exactly the same. You've seen me say the median age of the positives is much younger but that's only part of the story. It's not killing near as many no matter what the population. Virus weakening? Seems that way...
Bed availability in FL:

Yeah... don't listen to the panic. Florida is just fine.

Georgia. 6 deaths. 45% of deaths in NH's. Testing is up 40% in a week in GA.
Hosp: 1000--> 1056--> 1124--> 1135--> 1184--> 1178--> 1236--> 1359 (+36%)
Found out GA has been testing migrant farm workers as well... all last week. This probably explains the high non-resident positives of nearly 500 on three separate days recently. The other interesting thing is that despite all of these hospitalizations, ICU has not changed and neither has bed availability in the state. Overnight ER observation with discharge home? Probably as ER bed capacity has fallen at the same time. Death epi curve in this state still looks very good:

New admits... not a problem either:

I'm not worried about GA either. There are some local hotspots but those are few. Half of new cases are under 40 in this state as well.

Louisiana. 9 deaths. 45.5% of total deaths are in NH's.
Hosp: 630--> 646--> 631--> 653--> 700--> 700--> 715--> 737 (+17%)
Vents.. 77----> 83---> 77---> 77----> 73-=-> 73---> 76---> 79 (+2%)

MS. 20 deaths, 18 of these are legacy deaths as far back as May 5th. 48.7% of deaths in NH's.
675 cases. Cases are trending younger here as well. 371 of those today were under 40 and 70% are under 50. These numbers are consistent with the national numbers I posted yesterday.
Hosp: 485--> 489--> 523--> 536--> 533--> 527--> 490--> 513 (+6%)
ICU... 148--> 151--> 157--> 157--> 153--> 169--> 149--> 158 (+1%)
Vent... 95---> 88----> 91---> 94----> 90---> 90----> 88---> 93 (-5%)
Deaths in the last 2 weeks remain low. Stable hospital metrics week over week. Hinds lead the way last week with almost 300 cases. Not surprising given how busy I hear it is in the Jackson area. Harrison county was a distant second at 141 cases last week but that has not translated into hospitalizations. That is first hand knowledge. I personally know two of the positives. This story will tell you where these are coming from in large part. Kid goes off to junior college for baseball. Gets tested, no symptoms, he is positive. They test his entire family. Sister is positive as is whole family. Sister is the girlfriend of my friend's son. Son tests positive. They are now testing his entire family. This is the guy I went fishing with 8 days ago. It's been 8 days so I'd be symptomatic by now and plus, we were never indoors. But that's how they are finding these cases. Massive track and trace efforts. That one positive caused at least 7 more and counting...

Alabama. 10 deaths. ~360 cases.
Hospitalizations 650--> 638--> 658--> 680--> 667--> 693--> 658--> 715 (+10%).
Up today a little but overall daily hospitalizations are not concerning:


California. 31 deaths. 48.3% of all deaths in NH's.
Hosp 4804--> 5065--> 5399--> 5522--> 5639--> 5790--> 5956--> 6179 (+29%)
ICU.. 1412--> 1421--> 1487--> 1523--> 1570 -->1562--> 1602--> 1686 (+19%)
California is slowing its roll back to freedom. But let's do a quiz shall we? In the image below, pick out the state that has required masks in all of it's major counties since April and statewide for several weeks now with a massive lockdown?

The other two are Iowa and SD. Which one is California? Hint: it's the one that doesn't look so good. But... but... but... masks!

LA county closed beaches for the 4th of July. You know, because that's where it spreads. They did that for this:

You cannot make this up... ICU usage is less than it was in April! We are dealing with idiots.

Arkansas. 6 deaths.
Hosp: 237--> 248--> 267--> 284--> 284--> 284--> 278--> 300 (+26%)
Vent... 57----> 58---> 61----> 63---> 66---> 65----> 63---> 63 (+5)
Only 7 admits today in Arkansas, however, it was low last Monday as well and picked back up. Have to see where it goes. Vent usage very stable.

Tennessee. Deaths 8. 2100 cases reported today with a massive backlog as mentioned. Deaths remain low but I imagine in TN the cases are all the rage and masks are the topic of choice.
Hosp: 416--> 416--> 416--> 401--> 446--> 475--> 484--> 512 (+23%)
Shelby county still stable. I haven't looked into the rest of the state much lately.

South Carolina. 4 deaths. 46.5% of deaths in NH's.
Hosp: 731--> 824--> 832--> 881--> 906--> 908--> 954--> 1032 (+41%)
Epi curve still looks ok. Let's see if the hospitalizations follow suit. Still plenty of bed capacity at 21-33% depending on the area. These numbers have barely changed in a week. Similar issues as with GA? ER boarding overnight with discharge home?

North Carolina. 10 deaths. 57.9% of deaths in NH's.
Hosp: 870--> 915--> 906--> 891--> 892--> 888--> 890--> 843 (-3%)
Well now... that looks nice. Let's hope that continues. I haven't heard much about NC in the news so things must be ok.

Arizona. 0 deaths today. 58.6% of deaths in NH's.
Hosp: 1992--> 2136--> 2270--> 2453--> 2110--> 2577--> 2691--> 2721 (+36%)
ICU.... 583----> 614----> 581---> 611---> 581----> 657---> 666---> 679 (+16%)
So... 30 more hospitalized patients right? Nah... AZ reported 17 new admits today and over 250 discharges. Again, statistically impossible. This dashboard is a joke. Now, let's get to some good news. ED visits are down 4 of the last 5 days... a lot. Discharges have been over 250 for 4 straight days. I'm telling you right now, the hospital numbers above are wrong... very wrong. But... Ducey caved today. Who needs real data though right when you can have a fancy dashboard that looks great and is user friendly? This rollback will get credit as numbers start to fall later this week. The last 3 days of hospital data is very favorable even if it sucks. It appears that Arizona is also in the 50% category of hosp with CV19 but not for it, based upon the math I showed you yesterday.

New York. Cases still under 1% positive.
ICU: 270--> 244--> 230--> 229--> 216.
Deaths 7 today. Single digits again!!!

New Jersey. 17 Deaths. 50.3% in NH's.
13--> 25--> 54--> 46--> 23--> 42--> 34
27--> 17

Hosp: 1033--> 1092--> 1196--> 1182---> 1118--> 1103--> 1014--> 978 (-8%)
OK, NJ drops below the 1k mark and as with all of the early hard hit states I'm going to drop reporting that and just go with ICU beds. 225 today.

Illinois. 14 Deaths. 55.1% of deaths are in NH's.
Hosp: 1628--> 1648--> 1614--> 1626--> 1516--> 1516--> 1464--> 1501 (-8%)

MA/PA. 35, 35 deaths, respectively. Dropped Michigan. Single digits for a while now.

Comments:

1. The next person that tells you these cases are not a function of testing you tell them that they suck at math:


2. Once the camera is thought to be off:


3. LOCKDOWNS DO NOT WORK! In the words of Jules from Pulp Fiction, "Then you know what I'm sayin'?" Bet the UK is really glad they did it, no?

Look at that lockdown drive that Rt down to 1... oh, wait... it was already there? Can't be because... science!

4. I'd be willing to wager a lot of money that if hospitals didn't have an incentive for CV19 diagnosis for reimbursement, hospitalizations would be falling everywhere. Let's not pretend we've got some virus that's different than everywhere else. It behaves the same everywhere...

Cheers RGers
 
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