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Hospital deaths are down to their lowest ever, yet cases are high. Could just be that we are testing whereas previously we were not. And the past case volume w

Hospital deaths are down to their lowest ever, yet cases are high. Could just be that we are testing whereas previously we were not. And the past case volume was much higher, we just didn’t capture an accurate data point. Doesn’t help that most States are changing how they log data. Tldr daily cases isn’t necessarily representative of actual covid infection rate

grey-area 6y ago
Deaths are a trailing indicator, they peak weeks after infections. Cases and then deaths went down due to significant lockdowns across the US, which saved many states like CA from the initial wave but left them extremely vulnerable to any second wave. NY is the only state that really saw the full potential impact, and caused a spike in national numbers some are mistakenly calling 'the peak'. Now US states reopened and cases are growing exponentially again and deaths will follow. The alternatives now are national quarantine with massive economic damage but saving more lives or megadeath with all the sorrow and disruption that brings, especially to the poor and disadvantaged.
- 0xy 6y ago
  >NY is the only state that really saw the full potential impact That's because of practices like dumping patients with COVID into nursing homes full of healthy elderly people. NYC was notorious for this, and that's why nearly half of all COVID deaths in the US were in nursing homes. >Now US states reopened and cases are growing exponentially again and deaths will follow This is a guess, but it ignores the dramatically different testing criteria. Now tests are available everywhere easily to practically anyone who wants one. At the "peak" there was huge constraints on testing kits (so only the sickest possible people got them). It also remains to be seen that lockdowns don't cause more deaths via economic destruction (poverty is directly linked to mortality) than COVID. So it is absolutely not established to say lockdowns are beneficial for health reasons.
  - darkerside 6y ago
    If it's just testing, why are hospitalizations up dramatically? I keep hearing the poverty argument and it seems baseless to me. Nothing is 100%, so I acknowledge all of these scenarios are hypothetical. Still, we're trading deaths that are very hypothetical for deaths that we understand relatively well. If you're really concerned about the poor, why not lead with solutions for that (e.g. increase funding for food banks, homeless shelters, and school lunches), instead of just tearing down solutions for COVID?
    - 0xy 6y ago
      Are you saying you don't believe poverty has a direct link to mortality? That's been repeatedly proven across a wide range of different sources. http://news.mit.edu/2016/study-rich-poor-huge-mortality-gap-us-0411 http://news.mit.edu/2016/study-rich-poor-huge-mortality-gap-... Or are you saying that forcing businesses to close leading to layoffs, bankruptcies and foreclosures (which has already begun) don't cause poverty? The scientists recommending lockdowns totally disregard these facts, among other health impacts of being forced to stay home (mental and physical).
      - darkerside 6y ago
        No, I'm saying that you've presented a false dichotomy, that we should be solving the COVID problem, and that if you think the solution needs to be amended or extended in ways that mitigate associated poverty-based mortality, you should present those amendments instead of treating the issue as a reason to do nothing.
  - take_a_breath 6y ago
    ==It also remains to be seen that lockdowns don't cause more deaths via economic destruction (poverty is directly linked to mortality) than COVID.== Curiously, what data would you need in order to determine which causes more deaths?
  - grey-area 6y ago
    NY made mistakes, the federal government has made worse mistakes and other states have compounded them.
- pessimizer 6y ago
  > cases are growing exponentially again and deaths will follow. The positive test number is not really connected to anything. The number of actual infections is probably an order of magnitude greater than the number of positive tests. The only somewhat worthwhile testing number is the percentage of tests given that come up positive, and that's not great - testing was focused on at-risk of death, older people, and has now become more general, including younger people who have a comparable tiny risk of dangerous complications. The previous group have been completely isolated, and are generally more isolated, so shouldn't be spreading the virus very quickly. You'd expect a higher proportion of positive tests if tests were being expanded to a younger, more social distance violating population. You wouldn't expect that to be an indicator of a significantly higher number of deaths or complications, because the rise is in people who are the least likely to have them, and is possibly an artifact of less-restrictive selection criteria for testing. I don't know anyone under 50 that has been tested (who weren't horribly sick) and my 89 year old grandparents were just tested for a second time. Social distancing restrictions being lifted also has a greater effect on younger people than older people, who frequently have been completely left out of that. My grandparents have been in the same room for nearly four months, and plenty of people that age are socially isolated at the best of times. Young people have been on protests, or coronavirus truthers testing their "strong immune systems" at bars and other social get-togethers. The death rate is at a fifth of what it was at peak. I'm currently as social distanced as I ever was (because I am risk averse), but I do not understand the insistence that the coronavirus threat is currently getting worse, especially since it seems to come with a deemphasis on the death/hospitalization numbers and an exaggeration of the precision of the cumulative absolute positive test as an indicator. It seems entirely political. George Floyd was murdered over a month ago, with massive attendant protests, and death rates are lower than they've ever been.
  - ethbro 6y ago
    Only one number that matters, the current / effective reproduction number [e.g. 0]. Everything else is a consequence of that. Deaths within cohort are decreasing because of increasingly effective treatment options [1]. The medical system works a lot like our adaptive immune system when faced with a novel pathogen, and it takes some time for best practices to be discovered and promulgated. Even symptom treatment is going to seriously decrease all-cause mortality. Having volunteered at a large US metro board of health over the last two months, booking testing appointments and arranging result reporting, I can tell you that a substantial number of under-50s are being testing. Primarily families and people with exposure to a known case. Effectively, there are a few groups the virus spreads through: (Won't shelter)|(Can't shelter) + (Won't protect)|(Can't protect) + (Will protect) + (Will shelter). The spikes we're seeing are a consequence of public health policy + current SEIR proportions in those various groups. As more vulnerable groups are increasingly infected, they become immune (aka recovered), which decreases the ability the virus to transmit in those groups. And left with less vulnerable groups of susceptible individuals, effective reproductive number decreases. The danger of SARS-CoV-2, given the relatively low mortality (and based on genetic modeling of potential mutations), was never that it was going to crest with Ebola-like proportions (you get it, you die), but that it was going to crest with a magnitude that would overwhelm available medical resources. Unfortunately, that crest is a binary proposition: either you have spare medical capacity (and serious Covid-19 patients receive high-quality care) or you have none (and serious Covid-19 patients receive no treatment). So the danger is not death rates now. The danger is (effective reproductive number) -> (expected case count) -> (serious, hospitalized cases of Covid-19) -> (exhausted medical capacity) -> (Italy-esque spike in deaths). [0] https://rt.live/ https://rt.live/ [1] https://blogs.sciencemag.org/pipeline/archives/2020/06/17/dexamethasone-for-coronavirus-infection https://blogs.sciencemag.org/pipeline/archives/2020/06/17/de... [2] https://blogs.sciencemag.org/pipeline/archives/2020/05/15/good-news-on-the-human-immune-response-to-the-coronavirus https://blogs.sciencemag.org/pipeline/archives/2020/05/15/go...
- csharptwdec19 6y ago
  > NY is the only state that really saw the full potential impact. IDK about that. MI Peaked around the same time as NY, locked down around the same time. If we look at the daily graphs both MI and NY are sticking around the same number of new cases per day.
fabian2k 6y ago
If increased testing was the cause, the rate of positive tests would decrease. But what is actually observed is that the rate increased in many states, so the increased number of cases is real. The amount of testing also didn't increase significantly in the last week or so in most states, but some states like Arizona, Florida, California or Texas still had drastically increased numbers of cases.

grey-area 6y ago

Deaths are a trailing indicator, they peak weeks after infections. Cases and then deaths went down due to significant lockdowns across the US, which saved many states like CA from the initial wave but left them extremely vulnerable to any second wave. NY is the only state that really saw the full potential impact, and caused a spike in national numbers some are mistakenly calling 'the peak'. Now US states reopened and cases are growing exponentially again and deaths will follow. The alternatives now are national quarantine with massive economic damage but saving more lives or megadeath with all the sorrow and disruption that brings, especially to the poor and disadvantaged.

0xy 6y ago
>NY is the only state that really saw the full potential impact That's because of practices like dumping patients with COVID into nursing homes full of healthy elderly people. NYC was notorious for this, and that's why nearly half of all COVID deaths in the US were in nursing homes. >Now US states reopened and cases are growing exponentially again and deaths will follow This is a guess, but it ignores the dramatically different testing criteria. Now tests are available everywhere easily to practically anyone who wants one. At the "peak" there was huge constraints on testing kits (so only the sickest possible people got them). It also remains to be seen that lockdowns don't cause more deaths via economic destruction (poverty is directly linked to mortality) than COVID. So it is absolutely not established to say lockdowns are beneficial for health reasons.
- darkerside 6y ago
  If it's just testing, why are hospitalizations up dramatically? I keep hearing the poverty argument and it seems baseless to me. Nothing is 100%, so I acknowledge all of these scenarios are hypothetical. Still, we're trading deaths that are very hypothetical for deaths that we understand relatively well. If you're really concerned about the poor, why not lead with solutions for that (e.g. increase funding for food banks, homeless shelters, and school lunches), instead of just tearing down solutions for COVID?
  - 0xy 6y ago
    Are you saying you don't believe poverty has a direct link to mortality? That's been repeatedly proven across a wide range of different sources. http://news.mit.edu/2016/study-rich-poor-huge-mortality-gap-us-0411 http://news.mit.edu/2016/study-rich-poor-huge-mortality-gap-... Or are you saying that forcing businesses to close leading to layoffs, bankruptcies and foreclosures (which has already begun) don't cause poverty? The scientists recommending lockdowns totally disregard these facts, among other health impacts of being forced to stay home (mental and physical).
    - darkerside 6y ago
      No, I'm saying that you've presented a false dichotomy, that we should be solving the COVID problem, and that if you think the solution needs to be amended or extended in ways that mitigate associated poverty-based mortality, you should present those amendments instead of treating the issue as a reason to do nothing.
- take_a_breath 6y ago
  ==It also remains to be seen that lockdowns don't cause more deaths via economic destruction (poverty is directly linked to mortality) than COVID.== Curiously, what data would you need in order to determine which causes more deaths?
- grey-area 6y ago
  NY made mistakes, the federal government has made worse mistakes and other states have compounded them.
pessimizer 6y ago
> cases are growing exponentially again and deaths will follow. The positive test number is not really connected to anything. The number of actual infections is probably an order of magnitude greater than the number of positive tests. The only somewhat worthwhile testing number is the percentage of tests given that come up positive, and that's not great - testing was focused on at-risk of death, older people, and has now become more general, including younger people who have a comparable tiny risk of dangerous complications. The previous group have been completely isolated, and are generally more isolated, so shouldn't be spreading the virus very quickly. You'd expect a higher proportion of positive tests if tests were being expanded to a younger, more social distance violating population. You wouldn't expect that to be an indicator of a significantly higher number of deaths or complications, because the rise is in people who are the least likely to have them, and is possibly an artifact of less-restrictive selection criteria for testing. I don't know anyone under 50 that has been tested (who weren't horribly sick) and my 89 year old grandparents were just tested for a second time. Social distancing restrictions being lifted also has a greater effect on younger people than older people, who frequently have been completely left out of that. My grandparents have been in the same room for nearly four months, and plenty of people that age are socially isolated at the best of times. Young people have been on protests, or coronavirus truthers testing their "strong immune systems" at bars and other social get-togethers. The death rate is at a fifth of what it was at peak. I'm currently as social distanced as I ever was (because I am risk averse), but I do not understand the insistence that the coronavirus threat is currently getting worse, especially since it seems to come with a deemphasis on the death/hospitalization numbers and an exaggeration of the precision of the cumulative absolute positive test as an indicator. It seems entirely political. George Floyd was murdered over a month ago, with massive attendant protests, and death rates are lower than they've ever been.
- ethbro 6y ago
  Only one number that matters, the current / effective reproduction number [e.g. 0]. Everything else is a consequence of that. Deaths within cohort are decreasing because of increasingly effective treatment options [1]. The medical system works a lot like our adaptive immune system when faced with a novel pathogen, and it takes some time for best practices to be discovered and promulgated. Even symptom treatment is going to seriously decrease all-cause mortality. Having volunteered at a large US metro board of health over the last two months, booking testing appointments and arranging result reporting, I can tell you that a substantial number of under-50s are being testing. Primarily families and people with exposure to a known case. Effectively, there are a few groups the virus spreads through: (Won't shelter)|(Can't shelter) + (Won't protect)|(Can't protect) + (Will protect) + (Will shelter). The spikes we're seeing are a consequence of public health policy + current SEIR proportions in those various groups. As more vulnerable groups are increasingly infected, they become immune (aka recovered), which decreases the ability the virus to transmit in those groups. And left with less vulnerable groups of susceptible individuals, effective reproductive number decreases. The danger of SARS-CoV-2, given the relatively low mortality (and based on genetic modeling of potential mutations), was never that it was going to crest with Ebola-like proportions (you get it, you die), but that it was going to crest with a magnitude that would overwhelm available medical resources. Unfortunately, that crest is a binary proposition: either you have spare medical capacity (and serious Covid-19 patients receive high-quality care) or you have none (and serious Covid-19 patients receive no treatment). So the danger is not death rates now. The danger is (effective reproductive number) -> (expected case count) -> (serious, hospitalized cases of Covid-19) -> (exhausted medical capacity) -> (Italy-esque spike in deaths). [0] https://rt.live/ https://rt.live/ [1] https://blogs.sciencemag.org/pipeline/archives/2020/06/17/dexamethasone-for-coronavirus-infection https://blogs.sciencemag.org/pipeline/archives/2020/06/17/de... [2] https://blogs.sciencemag.org/pipeline/archives/2020/05/15/good-news-on-the-human-immune-response-to-the-coronavirus https://blogs.sciencemag.org/pipeline/archives/2020/05/15/go...
csharptwdec19 6y ago
> NY is the only state that really saw the full potential impact. IDK about that. MI Peaked around the same time as NY, locked down around the same time. If we look at the daily graphs both MI and NY are sticking around the same number of new cases per day.

fabian2k 6y ago

If increased testing was the cause, the rate of positive tests would decrease. But what is actually observed is that the rate increased in many states, so the increased number of cases is real. The amount of testing also didn't increase significantly in the last week or so in most states, but some states like Arizona, Florida, California or Texas still had drastically increased numbers of cases.