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Are we tracking the wrong COVID-19 Metric?
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Replies: 28  

Are we tracking the wrong COVID-19 Metric?

emoji_events [26]
Apr 27, 2020, 4:50 PM

I'm starting to think we may be giving the total number of infections/new infections way more emphasis than we should. The numbers that really matter, and we should be focusing on, are "currently hospitalized" and "death". Since the beginning of April, there have been at least six studies in the USA on COVID-19 infection rates with two of the most recent being conducted by Stanford University and the University of Southern California. Regardless of who has conducted the study, the findings are all trending in the same direction; way more people have had COVID-19 than is reflected in the CDC total infection numbers. Once the dust has settled and more antibody testing is conducted, we are inevitably going to find that the overall COVID-19 infection rate is probably 4 times or more than is currently counted and the true morbidity rate of COVID-19 is a lot lower than it is now. I suspect the overall COVID-19 morbidity will drop to well below the 1% mark.

I don't think it is going too far out on a limb to say that the total infected/new infection numbers are not accurate and we really have no way of determining how many people are currently infected or have been infected/recovered since this virus hit our shores. Therefore, the only trustworthy numbers right now are "hospitalized" and "death" because we know those numbers are the most accurate. The reason is simple - we can physically count people that have been hospitalized and are currently in hospital beds and/or the morgue.

The current Government guidelines/phasing are based on "new infection" rates. By chasing "new infections" I feel that we are chasing the wrong metric. We really should be more concerned with "new hospitalizations". I contend that as long as we can mitigate and reduce the hospitalizations, the number of total infections/new infections is largely irrelevant. In my opinion we should be basing our actions on the hospital trends and not some 14 day running tally of new infections. Quite frankly, if the number of hospitalizations are going down and are manageable do we really care if the infection rate remains steady or even ticks up?

There seems to be an automatic assumption that the more people testing positive will equal more hospitalizations. This is the line the media and talking heads keep shilling. Early in our fight against COVID-19 that assumption was somewhat true because of who was receiving the tests (mainly those who had severe COVID-19 cases and were hospital bound), but that is not necessarily the case now. As we greatly increase random testing and testing among the mildly symptomatic population the morbidity rate is going to drop and so will the hospitalization percentages. The data is becoming clearer each day - the overwhelming majority of people who get COVID-19 aren't in any serious danger of dying or even being hospitalized. We know that there are certain segments of the population that are much more at risk than others of being hospitalized and we must be mindful of them. We can target these at risk groups for mitigation in order to reduce the numbers of hospitalization while allowing those not at risk to return to a more normal routine. At the end of the day, our concern is really about how many folks are hospitalized and not how many people get infected. So why don't we phase our public policy based on the hospitalization metric which we know to be accurate instead of new/total infections whose accuracy is questionable to begin with?


Other thoughts if you feel like reading it:
- Throughout all of March and into early April, the only folks being tested were those who were exhibiting seriously severe symptoms to warrant such a test. In other words - because we lacked adequate testing, about the only folks being tested were those whose symptoms were resulting in them being hospitalized or heading towards hospitalization.

- During this same period, we severely under counted the mild/less severe symptomatic COVID-19 cases. Remember the commercials from the CDC that instructed folks who exhibited COVID-19 symptoms to call their Doctor instead of going to the Doctor's office. The idea was for Doctors to determine individual risk over the phone by having the non-life threatening cases to self isolate at home and treat the disease as they would a common cold/flu. Considering the vast majority of COVID-19 cases fall into this "mild disease" category, chances are there are/were thousands upon thousands of COVID-19 infections that were never tested nor counted in the positive COVID-19 numbers we see today.

- As we have dramatically increased our testing capabilities, we are now able to test those that are mildly symptomatic in addition to the severely symptomatic. So it is no surprise that the number of positive infections is increasing as would be expected. In other words, we are now able to confirm a lot of the mild cases that were not getting tested in March and early April. The rise in positive infections would seem to also validate the USA studies (e.g. Stanford and USC studies) that indicate many more people have had the virus than the current infection numbers indicate.

- All of the above is in regards to symptomatic testing. However, we know that significant portions of the population are asymptomatic and until we are able to do enough randomized testing we will not be able to extrapolate those asymptomatic numbers to provide any useful information.

- Likewise, until we have large scale randomized antibody testing, we will also not be able to provide any realistic extrapolations to determine a realistic number of the total population that has already had the disease but was not previously counted.

- Trying to attribute any significance out of the number of new test positives vs previous test positives is in some ways an exercise in futility because the scale of testing and the types of cases now being tested has changed considerably over the last month.

- A lot is being made over getting a vaccine before opening up the country. What if we never get a vaccine for COVID-19? Not to be negative, but there are no guarantees we ever come up with an effective COVID-19 vaccine. Considering we don't have a vaccine for the common cold (a Coronavirus derivative), we cannot assume a COVID-19 vaccine is a given. Therefore, it's probably wise to start building some herd immunity among the majority "not at risk" population now.

2022 orange level memberbadge-donor-10yr.jpg flag link

at this point i think they're just using whatever metric

emoji_events [9]
Apr 27, 2020, 5:26 PM

they can to drag in out in order to affect the campaign/voting season. If we're not all back to work by mid May to late May then you'll know for sure. As many people that are coexisting at grocery stores, walmart, lowes, etc. and the numbers haven't spiked (even though we're all congregating at the same spots) then we should be good to resume using precautions and care that we've all acquired. At this point i'm convinced this is about mail in balloting and pinning a collapsing economy on the current administration in order to swing the vote.

they can at least require proper PPE for a certain period and get struggling families back to making money again. At this point we're just waiting around for the boogey man.

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Re: at this point i think they're just using whatever metric

emoji_events [5]
Apr 27, 2020, 5:31 PM

if they can get the vote by mail and ballot harvesting going to ensure things go a certain way on Nov 3, then by January 20, 2021 the need for a vaccine goes away, the need for more testing goes away, pretty much all the panic will just magically go away.

2022 orange level memberbadge-donor-15yr.jpg flag link


Naw, they'll still push the vaccine need. 300 million times

[3]
Apr 27, 2020, 6:05 PM

$100 is a lot of cabbage. Not to mention the national registry and surveillance programs.

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Re: Naw, they'll still push the vaccine need. 300 million times

[2]
Apr 27, 2020, 6:12 PM

Health care is a human right and I'm pretty sure it has to be provided for free.

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Re: Naw, they'll still push the vaccine need. 300 million times


Apr 27, 2020, 8:46 PM

Health care in the good ole USofA cost us more than anywhere in the world, and we are suppose to be the richest country in the world, Go Figure!!!

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Re: Naw, they'll still push the vaccine need. 300 million times

[1]
Apr 28, 2020, 8:20 AM

Healthcare is the product of someone else's labor and something you have zero right to.

Thats literal slavery.

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Re: at this point i think they're just using whatever metric

[1]
Apr 28, 2020, 1:39 AM

El Tigre 1 said:

they can to drag in out in order to affect the campaign/voting season. If we're not all back to work by mid May to late May then you'll know for sure. As many people that are coexisting at grocery stores, walmart, lowes, etc. and the numbers haven't spiked (even though we're all congregating at the same spots) then we should be good to resume using precautions and care that we've all acquired. At this point i'm convinced this is about mail in balloting and pinning a collapsing economy on the current administration in order to swing the vote.

they can at least require proper PPE for a certain period and get struggling families back to making money again. At this point we're just waiting around for the boogey man.




First, the handling of the Pandemic is by the Trump administration, not the Dems. So the idea that testing and mortality rates are being manipulated for mail-in ballots and elections indicts the Trump administration, not the Dems. They control the White House and the Senate, but somehow the Dems are
"Drag it out in order to affect the campaign voting season" appears to me to one of those right-wing conspiracy theories that, on its face, is inconsistent with the facts. Trump, who has the only power to affect mitigation for the virus, would be a fool to drag it out. But right-wing 'lying machines' will have you believe the Dems are dragging out a freaking pandemic. Hannity and Limbaugh will go down in history as traitors and propagandists during a national emergency. And they do it for money, not for any real conservative cause.

All along this pandemic has been characterized as being used "as an attack on Trump" when in fact, he has had the power to mitigate it from the beginning and chose not to. Bring in the military, give them test kits to employ across the country.

In only 1 month, this virus has killed more people than died in car crashes in 2019. In 1 month, it has killed more than all the people who died of the flu, all of 2019. In 1 month!

In my view, the asymptomatic are the REAL problem at this stage. Estimates, data...none of that matters. It's not whether the asymptomatic person dies, it's how many does he/she infect before THEY start feeling symptoms.

If I were the President, I would mobilize the military, the National Guard and every other body I could get my hands on and test the entire population mandatorily. All those infected would be instantly quarantined and prevent their spreading it. We've tested over 5 million people so far. That is a pittance in a country of 330 Million.

Testing and quarantine is the only fast way to mitigate this disease. Mobilize the entire country, use the Defense Production Act and force hundreds of additional labs to work on a vaccine. Force manufacturers to flood out PPE so the doctors, nurses, and corporals who are doing the testing and treating are properly protected.

Right now, the states are bidding against each other for PPE. That is absurd, expensive, time-consuming, and fractionalizing. It's like we're putting out a house fire but the only water we can use is bottled that we buy at Walmart! It's nuts. And people continue to die. If "only" 1% of Americans are hospitalized or die, that is 30 million people. We don't have a plan, we are floundering around in the dark hoping it will go away when it gets warm. Well, Jamaica's infection rate doubled in 1 week...and it's consistently 85 degrees there. Heat, Light, or Injectible Disinfectants just aren't going to get it either. TEST, TEST, TEST. It's the only way to open up the normal life again.

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Re: Are we tracking the wrong COVID-19 Metric?

[1]
Apr 27, 2020, 5:27 PM

Interesting.....thanks for your work....Go Tigers.

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This thing has become political, therefore all logic is null

emoji_events [5]
Apr 27, 2020, 5:34 PM

All numbers should be treated suspiciously, all therapy results, and especially all death counts.

The dems in charge relish the power, the media wants to smear Trump, and Trump wants to look like a great leader.

As the year rolls on and the economic ramifications start to swamp the relatively miniscule death totals, the devastation that has been done will be made evident and it won't be pretty.

I hope there are some serious political consequences for all this.

2022 white level memberbadge-donor-15yr.jpg flag link

?????? I wouldn’t hold my breath on that!!***


May 2, 2020, 8:53 PM



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Re: Are we tracking the wrong COVID-19 Metric?

[1]
Apr 27, 2020, 5:36 PM

Back in the day when the bubonic plague, pneumonic plague, septicemic plague was killing people, I'm sure there were a lot of people that thought that it wasn't serious until they killed hundreds of thousands of people, and they were wondering if the professionals of deadly disease had a clue of what they were talking about, and thousands of those that thought that way met an early grave or were stacked in a pile and burned to nothing but ashes and then buried. Personally, I'm going to take the heath professionals as serious as serious is, and do what they say is the safest way to survive this one that is on a path of killing people!!!

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Re: Are we tracking the wrong COVID-19 Metric?

[2]
Apr 27, 2020, 5:39 PM

You are correct, sir. The news of the day should be the declining death rate each day. Instead, the news is if there will be a White House briefing today. What does the data say:

Day Deaths over 24 hrs
Tues 4-21 2,483
Wed 4-22 2,253
Thur 4-23 1,223
Fri 4-24 3,508
Sat 4-25 2,611
Sun 4-26 1,044
Mon 4-27 1,202

There are ups & downs, but the overall trend is good. You can make your own case about what the public should do; however, we should at least consider relaxing restrictions in areas that are less affected.

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Nice read. Thank you.

[1]
Apr 27, 2020, 6:31 PM

The best news we've had over the last week were the results of random surveillance studies done in California and later New York state and city. They all show a lot more spread with less deadly affects pervasive alongside. Symptoms or not, grabbing random samples throughout communities and workplaces is critical to gaining the upper hand and minimizing outbreaks until we know better how to kill it.

The hospitalizations and deaths were the numbers utilized to get us to shut it down and stay apart for these past six weeks (wow!) so as not to overwhelm. Those are definitely important figures still to keep front and center. New positives extrapolated out of sample testing will continue to shine light on how well our daily measures are adding up, where we can improve, and a lot more about the virus itself and its characteristics.

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Re: Are we tracking the wrong COVID-19 Metric?

[4]
Apr 27, 2020, 7:50 PM

The only metric that matters is the death per million. This is the only way to truly compare city to city or country to country. It also puts into perspective [ however tragic] how ridiculous our reaction to this. Deaths per million or even total deaths in the USA from Covid 19 pale in comparison to any other pandemic or even common flu. This is politically and media generated. We are killing an entire nation for nothing. Look at Sweden and other countries who refused to go along with the lockdown nonsense. Data is coming out now that shows countries like Sweden who have done nothing, show no meaningful difference than those countries that have locked down. Their death rate is lower than the US per million. In addition, they benefit from the 'Herd Effect'. By locking down, we are just slowing down the spread of the virus. With 99.9% of those affected showing no meaningful effects, we want it to spread so we can develop immunity and let this thing die out.

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Re: Are we tracking the wrong COVID-19 Metric?

[2]
Apr 27, 2020, 9:22 PM

That's the thing though , no scientific evidence yet that " herd immunity " can be counted on with this one .
Not to be a downer on that not e as well but they're seeing recovered people become sick again in China , Korea , Spain , Italy etc.
There's a lot of talk out there among the no-nots saying this is less than the flu by it's sheer numbers and stuff like that , but I fear that is terrifically short sighted and in a more dangerous sense , wishful thinking .

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DB23


Re: Are we tracking the wrong COVID-19 Metric?


Apr 28, 2020, 9:42 AM

In flu comparisons it seems to get lost that we've experienced more than a year's worth of flu death totals via Covid-19 in essentially two months time, with draconian extreme social distancing measures in place alongside. This is far from a hoax and hardly a media driven problem at hand. Sad part is the continued lack of widespread testing leaves us no closer to gaining a true picture of the severity and virality, feeding misinformation and competing narratives. It's like we're still at ground zero yet down $2.5 Trillion and counting.

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You might want to check those flu numbers


Apr 27, 2020, 11:41 PM

.

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Re: Are we tracking the wrong COVID-19 Metric?


Apr 27, 2020, 8:02 PM

Excellent write-up!

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One of the CDC triggers for lowering social distancing


Apr 27, 2020, 8:53 PM

requirements is “Downward trajectory of positive tests as a percent of total tests within a 14 day period (Flat or increasing volume of tests)”.

Initially tests were very limited. A small number of tests would tend to show high positive test percentages when administered to only the very sick _ and given small number of total tests (I.e. small denominator).

As testing increases, more negative tests may be likely given the less restrictive criteria for testing. More preventive testing of health care personnel , 1st responders, essential workers, etc. would seem to drive more negative tests on a percentage basis. Also testing healthy folks as part of contact tracing may show lower positive test percentages.

I agree there is a much higher overall infection rate of the total population. Even with that, it still is more likely that an additional test will be negative with less restrictive criteria. Given the above logic, more testing should make it easier to hit “lower positive test percentages”.

Test healthy people.

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When you take out the deaths attributed to the Chinese flu

[2]
Apr 27, 2020, 8:53 PM

that are not related to it, they may be even smaller......

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TL;DR***


Apr 27, 2020, 9:50 PM



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This is what I track in NC and Moore County

[1]
Apr 27, 2020, 10:37 PM

my graphs are a bit different too

https://docs.google.com/spreadsheets/d/1i57E6O1yDq_FvQGNjiAH3T2RPJeqMVV7_rYruIP9KWU/edit?usp=sharing

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Re: Are we tracking the wrong COVID-19 Metric?


Apr 28, 2020, 1:16 AM

Not sure, haven't finished reading OP, but will.

This I find disturbing, this is a picture of infections in North America. Canada actually had it's first case before ours and 80% of Canadians live within 100 miles of the U.S. border. And look at Mexico and central America.

Look how much we stand out, it's a tragedy and a crime:

COVID-19 Map

https://coronavirus.jhu.edu/map.html


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Re: Are we tracking the wrong COVID-19 Metric?


Apr 28, 2020, 8:15 AM

CDC puts out a number they call 'Confirmed Cases', which, we are finding out, is a far cry from the total number of people infected. So, the reported numbers are really not very helpful and is probably very misleading when considering the government has been using this information to set policy. Ditto for the information put out by most of the other nations on the list.
The original policy was determined in order to minimize the number of hospitalizations and not overwhelm the system. That worked in spades in almost all of the country (NY, NJ and Detroit are exceptions). Seeing as most of the country has excess hospital capacity, to continue to stay locked down or shut down would only increase the likelihood that the economy will tank in a big way. I believe there are elements that want this. Maybe lets open up some and see what happens? I suspect it won't be so bad.

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To be blunt, anybody that thinks that we need a wait


Apr 28, 2020, 8:14 AM

for a vaccine to reopen the country is an idiot.

2022 white level member flag link

the right ‘person’


May 2, 2020, 7:32 PM

Can prove OR disprove anything he wishes to with statistics. IF we know how much “ excrement” a House fly expels in a single day we can statistically predict how many days we have until we are knee deep in fly $hit but it likely will not happen. I made a C in Statistics so take this with a grade of slaw.

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+1 Your post mirrors my thoughts exactly

[1]
May 2, 2020, 8:55 PM

And I’m a healthcare worker on the “front lines”... if that even matters.

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Please condense to 50 words or less


May 4, 2020, 4:12 PM

so I can understand what you just tried to say. And in this you will have achieved something few have: the art of communicating effectively. Good luck. "Murder your babies".

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