COVID-19 Thread

[PeaveyFury]

If statewide business reopening policy was more prevalent then California wouldn't be exploding in their daily case totals, WI would be going nuts, etc. This recent surge in certain states seems to have alot more to do with areas requiring heavy AC use for common life - i.e., people staying indoors breathing largely recycled air rather than mostly fresh air.

 

But based on the current data, Wisconsin IS starting to go nuts, for the record. And it's hard to ignore that a lot of the current outbreak is happening in states that either A)opened without many restrictions, or B)opened before most other places did.

 

The last thing I'd add to this is even with the shutdowns, there was going to be a time a few months after they ended when the virus would "peak" - many times that peak was forecast to be in June/July even with stay at home measures. We are basically at that point on the calendar, so it's not exactly a surprise that other parts of the country appear to be "peaking" regardless of what they did back in April or May.

 

But wasn't the narrative just a couple of weeks ago that the 'peak' in states like Minnesota happened around Memorial Day? Clearly, that wasn't actually the case and it has proven false, much like the hopes that were pinned to the 'wait until the weather gets warm' narrative as well, which was extremely prevalent back in early spring. The point is, regardless of what the cause is, the virus HASN'T slowed down in the summer, and cases are ballooning, and it absolutely has to do with the lessening of restrictions.

 

Also, there's growing anecdotal evidence that both positive test count and infection rate parameters aren't closely tied to individual cases to the point of accurately projecting COVID-specific hospitalizations and most importantly COVID-linked deaths - especially if trying to use the rates initially established this spring while using results of very limited to no population-wide testing. Hospitals test patients multiple times, especially if a person tests positive initially. How various states report these totals from hospital systems and labs is not entirely consistent in both information sources and timing of how data is reported/tallied on a daily basis - that helps to explain some of the discrepancies with ICU/hospital bed use/hospital discharges/specific dates of COVID-related deaths, etc.

 

This also sounds like interesting data to review! I'd certainly be interested in seeing the source material here, in addition to the data on typical ICU-capacity rates from your post a few days back, as I think that would add a lot of insight into what's going on currently.

[PeaveyFury]

If statewide business reopening policy was more prevalent then California wouldn't be exploding in their daily case totals, WI would be going nuts, etc. This recent surge in certain states seems to have alot more to do with areas requiring heavy AC use for common life - i.e., people staying indoors breathing largely recycled air rather than mostly fresh air.

 

But based on the current data, Wisconsin IS starting to go nuts, for the record. And it's hard to ignore that a lot of the current outbreak is happening in states that either A)opened without many restrictions, or B)opened before most other places did.

 

The last thing I'd add to this is even with the shutdowns, there was going to be a time a few months after they ended when the virus would "peak" - many times that peak was forecast to be in June/July even with stay at home measures. We are basically at that point on the calendar, so it's not exactly a surprise that other parts of the country appear to be "peaking" regardless of what they did back in April or May.

 

But wasn't the narrative just a couple of weeks ago that the 'peak' in states like Minnesota happened around Memorial Day? Clearly, that wasn't actually the case and it has proven false, much like the hopes that were pinned to the 'wait until the weather gets warm' narrative as well, which was extremely prevalent back in early spring. The point is, regardless of what the cause is, the virus HASN'T slowed down in the summer, and cases are ballooning, and it absolutely has to do with the lessening of restrictions.

 

Also, there's growing anecdotal evidence that both positive test count and infection rate parameters aren't closely tied to individual cases to the point of accurately projecting COVID-specific hospitalizations and most importantly COVID-linked deaths - especially if trying to use the rates initially established this spring while using results of very limited to no population-wide testing. Hospitals test patients multiple times, especially if a person tests positive initially. How various states report these totals from hospital systems and labs is not entirely consistent in both information sources and timing of how data is reported/tallied on a daily basis - that helps to explain some of the discrepancies with ICU/hospital bed use/hospital discharges/specific dates of COVID-related deaths, etc.

 

This also sounds like interesting data to review! I'd certainly be interested in seeing the source material here, in addition to the data on typical ICU-capacity rates from your post a few days back, as I think that would add a lot of insight into what's going on currently.

 

I just hope when the liver transplant patient is notified about having COVID, they are kindly reminded they are an asymptomatic case and wouldn't ever need to be in a hospital for it for their own peace of mind...IMO needing a new liver sucks way worse! However, a patient in a hospital for a liver surgery that happens to have asymptomatic COVID is logged as a COVID hospitalization until they get discharged - as it's likely they would need to recover in a COVID-specific section of the hospital because they are potentially infectious despite being asymptomatic.

 

Doesn't this require the assumption that that liver transplant patient wouldn't be at a high risk of COVID complications/ICU needs because of that very underlying condition?

[tmwiese55]

It really is sad that a lot of the states that unwound restrictions did so with the noble intent to help businesses survive, but the haphazard way things opened too quickly is likely going to end up harming a lot of those businesses more in the long run than if they had just stayed closed a bit longer.

 

Which is literally the argument that health officials were making back in May....

 

Compliments on the phrasing here in the first paragraph. Much better than the shouting and acting like those people were deliberately trying to harm people. People can just be wrong and make incorrect decisions, especially in an unprecedented situation trying to juggle many issues at once like in this case, without being intentionally harmful.

[FVBrewerFan]

Pretty simple, many more young people getting tested in some of these states. Positives go up, but death rates way down. Which is all that really matters.

 

As far as when/ how states have opened there is no correlation between that and case spikes. Those states opened two months ago, and just recently saw AZ, TX, FL rise in cases. Why now? Why haven't all states experienced this trend? Because there is no correlation. No matter what states do, we will see hot spots pop up. That's not unexpected.

[Fear The Chorizo]

Doesn't this require the assumption that that liver transplant patient wouldn't be at a high risk of COVID complications/ICU needs because of that very underlying condition?

 

Potentially, but if you're an alcoholic who needs a new liver and the only reason you became aware you have COVID is because the hospital tested you for it prior to a procedure, I wouldn't consider them any higher risk of requiring an ICU bed than if they tested negative for COVID. A liver transplant, heart surgery, other major procedure patient is going to require an ICU bed no matter what - if they are an asymptomatic positive COVID case they likely take up a bed in a portion of the hospital established for COVID patients to reduce spread. They aren't in ICU because of COVID, they are recovering from a major surgery.

 

I really doubt hospitals are seeing a swell of patients showing up that can't taste anything and undergoing respiratory failure requiring intubation and doctors are saying "hey, while you're in here recovering from from the 'Ro' we realized you need a bunch of new organs, so let's get that taken care of, too."

 

But wasn't the narrative just a couple of weeks ago that the 'peak' in states like Minnesota happened around Memorial Day? Clearly, that wasn't actually the case and it has proven false, much like the hopes that were pinned to the 'wait until the weather gets warm' narrative as well, which was extremely prevalent back in early spring. The point is, regardless of what the cause is, the virus HASN'T slowed down in the summer, and cases are ballooning, and it absolutely has to do with the lessening of restrictions.

 

During the extended lockdown, MN health officials figured the peak in the state would be late June or into July assuming stay at home measures continued through most of May. They started lifting restrictions in mid to late May, then the George Floyd issue happened right as hospitalizations/new cases were climbing in late May and many said the state was headed for disaster since the true peak hadn't yet hit. Today, a full month after protests and rioting were occurring, the state reported 5 new deaths with a hospitalization total similar to early April when the initial wave was just starting to climb despite a ton of tests. I fully expect MN cases to climb again later this summer just like everywhere else because testing numbers is what is driving case counts. Based on both hospitalization and death rates compared to case counts, the virus has indeed slowed down in terms of its impact on people's health - if its a diminished virus it doesn't kill as many people as it did months ago...that's a very common occurrence with viruses as they mutate/evolve.

[tmwiese55]

I'd agree not enough info yet to know much for sure. But to the why now question? Because of exponential growth and that they keep opening more and more and people get looser and looser. So not so much just two weeks after someone gets it, but then the 2-4 people they infect who infect 2-4 more and so and so and so on. That takes time to build up. As you just said though, spikes were always gonna happen. When you identify some like it seems in a few states, well then address it like they seem to be doing. Still holding out hope here that this data is still early enough and levels off but as days go by I'm getting less optimistic on that.

 

Our trends and comps to Europe look so much worse though, no way around that data I can come up with.

[jerichoholicninja]

What exactly are we trying to accomplish right now? I haven't heard "flatten the curve" in months. It seems like there is no clear end game here and everyone's opinion of how things are going is dictated by their own politics.

[PeaveyFury]

Doesn't this require the assumption that that liver transplant patient wouldn't be at a high risk of COVID complications/ICU needs because of that very underlying condition?

 

Potentially, but if you're an alcoholic who needs a new liver and the only reason you became aware you have COVID is because the hospital tested you for it prior to a procedure, I wouldn't consider them any higher risk of requiring an ICU bed than if they tested negative for COVID. A liver transplant, heart surgery, other major procedure patient is going to require an ICU bed no matter what - if they are an asymptomatic positive COVID case they likely take up a bed in a portion of the hospital established for COVID patients to reduce spread. They aren't in ICU because of COVID, they are recovering from a major surgery.

 

Sorry, I think you're very much missing my point: If a person who needs a heart transplant shows up at an ER and tests positive for COVID, they're not there to get the heart transplant, they're there because they're showing serious symptoms of the COVID.

 

Knee replacement? Sure. But people with underlying conditions needing major medical procedures aren't showing up to the hospital not knowing they have COVID....

[Fear The Chorizo]

Our trends and comps to Europe look so much worse though, no way around that data I can come up with.

 

Look at confirmed case fatality rate - the US sits between Liberia and Indonesia, 31st in the world despite having by far the most confirmed COVID-related deaths. European nations are all over the top 10-20 countries in that stat, because aside from Germany they really haven't widely expanded their testing to the degree the United States has.

 

The case count spike seen in parts of the US is tied directly to testing people 50 yrs and under as part of a widescale return to work initiative over the past month-6 weeks. With the exception of Germany, european countries really haven't embarked on wide scale testing for their younger populations, particularly on a per capita basis.

 

It's easy to keep case counts from spiking when you don't bother testing...Austria sure has it down

 

https://news.yahoo.com/almost-half-virus-hit-austria-ski-resort-antibodies-165114333.html

[PeaveyFury]

Pretty simple, many more young people getting tested in some of these states. Positives go up, but death rates way down. Which is all that really matters.

 

As far as when/ how states have opened there is no correlation between that and case spikes. Those states opened two months ago, and just recently saw AZ, TX, FL rise in cases. Why now? Why haven't all states experienced this trend? Because there is no correlation. No matter what states do, we will see hot spots pop up. That's not unexpected.

 

This seems like a hard rationale to accept. Those three states specifically have three things in common: limited restrictions in the early stages or slow to shut down, early re-openings, and a populace that has struggled to socially distance.

[PeaveyFury]

Curious about the return to work initiative testing that I've seen mentioned a couple of times. It does seem that a lot of the new cases are skewing younger, but in Wisconsin at least, those have largely been linked to college-aged students attending crowded bars. If that is indeed the case, they'd only be testing positive because they're exhibiting symptoms and feel the need to be treated.

[Fear The Chorizo]

Tons to unpack in this tweet thread below and I don't necessarily agree with all points attempted to be made...but pretty interesting nonetheless when looking for reasons/factors for case spikes and hospitalizations climbing among COVID-infected people in the US.

 

https://threadreaderapp.com/thread/1276494896132534277.html

[Fear The Chorizo]

Curious about the return to work initiative testing that I've seen mentioned a couple of times. It does seem that a lot of the new cases are skewing younger, but in Wisconsin at least, those have largely been linked to college-aged students attending crowded bars. If that is indeed the case, they'd only be testing positive because they're exhibiting symptoms and feel the need to be treated.

 

Or its those same kids needing to be tested for summer jobs at bars/restaurants/service companies that have personal interaction with clientele, or contact tracing actually prompted them to get tested - exhibiting symptoms is no longer a requirement for getting tested for COVID for anyone, including youngsters.

[PeaveyFury]

Curious about the return to work initiative testing that I've seen mentioned a couple of times. It does seem that a lot of the new cases are skewing younger, but in Wisconsin at least, those have largely been linked to college-aged students attending crowded bars. If that is indeed the case, they'd only be testing positive because they're exhibiting symptoms and feel the need to be treated.

 

Or its those same kids needing to be tested for summer jobs at bars/restaurants/service companies that have personal interaction with clientele, or contact tracing actually prompted them to get tested - exhibiting symptoms is no longer a requirement for getting tested for COVID for anyone, including youngsters.

 

This may be accurate elsewhere, but I'm virtually certain it's not accurate in Wisconsin. To be tested even at the National Guard sites, you have to have potential exposure to a case or be exhibiting symptoms.

[Fear The Chorizo]

Fever or chills

Cough

Shortness of breath or difficulty breathing

Fatigue

Muscle or body aches

Headache

New loss of taste or smell

Sore throat

Congestion or runny nose

Nausea or vomiting

Diarrhea

 

These are the current list of COVID symptoms...I can check at least 3 of these off daily depending on what mood my kiddos are in;). Right now if a person wants or needs to get tested, they can get tested if they do even a little digging no matter what state they live in.

 

It's also not very difficult to drum up a "potential exposure" situation either - and anecdotally I know my company has had back to work testing requirements for employees performing work at jobsites that requires out of town travel or potential exposures to either individuals or locations that knowingly had COVID. I've been tested 5 times myself since early May and they were entirely due to work-related project requirements.

[PeaveyFury]

These are the current list of COVID symptoms...I can check at least 3 of these off daily. It's also not very difficult to drum up a "potential exposure" situation either - and anecdotally I know my company has had back to work testing requirements for employees performing work at jobsites that requires out of town travel. I've been tested 5 times myself since early May and they were entirely due to work-related project requirements.

 

I find a thesis of hundreds of college-aged kids choosing for no apparent reason to "drum up" a scenario where they have a potential exposure to get tested for COVID somewhat hard to accept. Far more likely that they're tested because they showed up at the Dr. with symptoms or went to a community testing site because they felt they needed to, right?

[Machu Peach]

But wasn't the narrative just a couple of weeks ago that the 'peak' in states like Minnesota happened around Memorial Day? Clearly, that wasn't actually the case and it has proven false.

 

Why do you think this? The data I'm seeing show that it's pretty clearly 'peaked' around Memorial Day. Off of the state website (https://www.health.state.mn.us/diseases/coronavirus/situation.html)

[PeaveyFury]

But wasn't the narrative just a couple of weeks ago that the 'peak' in states like Minnesota happened around Memorial Day? Clearly, that wasn't actually the case and it has proven false.

 

Why do you think this? The data I'm seeing show that it's pretty clearly 'peaked' around Memorial Day.

 

I think your point is fair- death rates have declined, hospitalizations have steadied, though still at a fairly high rate vs. even the heart of the early onset and quarantine in April. I think the idea that the certainty that the 'peak' has happened considering that was the assumption elsewhere until the last two weeks is problematic.

[Machu Peach]

I understand that there's a unstated reason why some are focusing so hard on AZ, TX, and FL, but CA is experiencing a similar increase in new infections. It would be good not to ignore it when attempting to determine the cause of the increase.

 

CA state website (https://public.tableau.com/views/COVID-19PublicDashboard/Covid-19Public?:embed=y&:display_count=no&:showVizHome=no)

[Machu Peach]

But wasn't the narrative just a couple of weeks ago that the 'peak' in states like Minnesota happened around Memorial Day? Clearly, that wasn't actually the case and it has proven false.

 

Why do you think this? The data I'm seeing show that it's pretty clearly 'peaked' around Memorial Day.

 

I think your point is fair- death rates have declined, hospitalizations have steadied, though still at a fairly high rate vs. even the heart of the early onset and quarantine in April. I think the idea that the certainty that the 'peak' has happened considering that was the assumption elsewhere until the last two weeks is problematic.

 

Non-ICU hospitalizations have decreased by 50% and ICU hospitalizations have decreased by 40% since 'around Memorial Day'. To say that they are 'steadied' is disingenuous.

 

Also, you specified Minnesota not 'elsewhere', so I provided data on Minnesota.

[PeaveyFury]

Non-ICU hospitalizations have decreased by 50% and ICU hospitalizations have decreased by 40% since 'around Memorial Day'. To say that they are 'steadied' is disingenuous.

 

Hospitalizations have been flat for nearly two weeks, so implying that they're on a steady decline would also be disingenuous. By 'stabilizing', I was referring to the flat, fairly consistent nature of the data recently.

 

Also, if you're curious about why AZ, TX, FL were singled out previously, I'd encourage you to read further back in the thread for further clarification.

[OldSchoolSnapper]

Pretty simple, many more young people getting tested in some of these states. Positives go up, but death rates way down. Which is all that really matters.

 

As far as when/ how states have opened there is no correlation between that and case spikes. Those states opened two months ago, and just recently saw AZ, TX, FL rise in cases. Why now? Why haven't all states experienced this trend? Because there is no correlation. No matter what states do, we will see hot spots pop up. That's not unexpected.

 

Maybe because those states are miserably hot now and people were actually outside 2 months ago?

[nate82]

Hear me out in this to stop the spread of COVID we should just build a bunch of human sized hamster balls. If you need to go anywhere you just get in the hamster ball and walk around. Think of it it would cure COVID and diabetes! You could even have these arm sockets that could be made of plastic rubbery stuff and you could grab things with them.

 

PURE GENIOUS RIGHT HERE!!!!!! You can thank me later!

[RobertR]

The bars seem to be the biggest vector for the resurgence. Which I think makes logical sense.

 

That, to me, is the low hanging fruit to concentrate on. And, maybe something that there's common ground to do something about, pass some sort of bill to financially shore up the bars so that they can reopen when safer, crack down on ones that aren't enforcing social distancing, and see if that helps. It beats shutting down large swathes of the economy.

[homer]

I understand that there's a unstated reason why some are focusing so hard on AZ, TX, and FL, but CA is experiencing a similar increase in new infections. It would be good not to ignore it when attempting to determine the cause of the increase.

 

CA state website (https://public.tableau.com/views/COVID-19PublicDashboard/Covid-19Public?:embed=y&:display_count=no&:showVizHome=no)

 

Yes, CA is also experiencing a big spike in cases. As is North Carolina, South Carolina, Georgia, Louisiana, Tennessee, Alabama, etc...methinks it's weather-related.

 

The good news is the fatality rate is dropping. Apparently the spike is caused by younger people who are less likely to die. But it has also caused a big spike in hospitalizations in many of the above states. Will it get to the point where they reach bed/resource capacity? Remains to be seen.

 

My fear is that this thing is going to go bonkers again up north come late October.