COVID-19: Chapter 4 - OPEN FOR BUSINESS

You mean I’m out here getting sunburnt like a charred hot dog for nothing? Dammit!

I think one thing that’s being missed here is that the average severity of cases hospitalized is impacted by the amount of hospital capacity available.

In other words, let’s say you have 1,000 hospital beds available. Let’s say 10% of cases need hospitalization and like 5% need intensive care. If you have 5,000 cases in your area, you’re going to see 500 hospitalizations and 250 intensive cases. Half are severe. If you have 10,000 cases in your area, you’re going to see 1,000 hospitalizations and 500 will be severe.

But if you have 20,000 cases, you’re still only going to have 1,000 hospitalizations. So what happens? Well, half the people who need hospitalization get turned away, and you’re almost entirely treating severe cases.

When Italy got hit the first time they were so overrun that they were turning away old people with severe cases. So the doctors in the hospitals were seeing like 100% severe cases.

Now, if they’re not at capacity, they’re probably admitting and treating a lot more mild cases. It doesn’t necessarily mean that COVID-19 is changing. Anecdotally, their experience is changing, but it’s not for the reasons that people might first assume/hope for.

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This squares with reports we saw this very morning from Houston that the disease is increasing in both size and severity from their perspective.

This could be exacerbated a bit by people not going to get tested for mild illness when things are more locked down. You could probably confirm/deny by looking at positive rates and/or the lag between changes in SDI and confirmed cases. If SDI is impacting testing directly, that should show up immediately, whereas if it’s influencing infections, that should show up in testing with a lag.

Testing site in Houston

https://twitter.com/alexdstuckey/status/1276653523636273152?s=19

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How is that not a drive thru test facility?

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I’m really sorry to hear this. It’s time to get fired. Perhaps show up in full head to toe PPE with a face shield. “Ready for the new responsibilities, boss!”

If they’re consumer facing, talk to the media or something (check with an employment lawyer to make sure this doesn’t give them cause).

This is true, from what I’ve heard from China. The severity of infections from people catching it after the first lock down is markedly less than originally.

Talking to the media would be a great way to get fired for cause.

This is the great hope, imo. But it’s unfortunately not supported in the US’s current case/mortality stats. 300-800 deaths per day with 20,000-25,000 cases per day (and perhaps 3-5x more infections than that) is right around where you’d expect to be with a disease with a 0.5% IFR.

Most of the perceived drop in mortality over May and June can probably be attributed to expanded testing capturing a greater and greater share in cases.

We are likely to see quite a bit of lag this time around since most people getting sick are younger, and we’ve learned the importance of managing vulnerable populations carefully. But it will reflect in the mortality stats, sooner or later.

If we don’t see a significant mortality bump (>1,000 deaths/day) by the end of July, then I think there will be a strong case that the disease is for some reason weaker.

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What do you consider to be ‘immediately’? Seven days?

I haven’t found any data to suggest anything of substance happens shorter than 7 days after the SDI reduces when I was doing it at the daily level. The only place I thought might be 6 days was Michigan, but it didn’t pan out when this idea was in its infancy. The absolute latest effects I found when doing it at the daily level were after 10 days (a few were at 9, but most were at 7). Changing it to the weekly average really made it clear, to me. My original thought was 14 days was when we would start to see effects based on incubation period. That seems to have held almost everywhere except a few outliers like Maine (seems like a testing/reporting issue, but not really sure).

My hypothesis right now is that it usually takes roughly 5 days to present symptoms, at which time a person might go try to get a test (could take up to two days depending on the location). I think the ‘average’ result return is probably around 4 days in most places (Nevada’s case bump on Saturday was supposedly due to slow result returns of 3 or 4 days). That puts the earliest (if correct) result reporting at 11 days (would show up in the second week of the 14 day period showing the bump). My tracking is also going from Wed-Tue each week at the state level if that makes an appreciable difference to analysis.

Based on some of your posts, you may be the best person to go into these graphs vs. testing to figure out if this 14 day bump is reliable and why it is if it is. I have the testing/new case data from the relevant period (post Memorial Day weekend), but it’s organized very poorly and would take a little time to get to you.

Not sure about that particular facility, but I know lots of cities that have opened up walk in testing facilities because not everyone has cars. Some of the ones in DC have had 5 hour waits.

Sure but I would expect murders to go way up as everyone has to spend a lot more time with their families.

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https://twitter.com/maddow/status/1277680390677975041?s=19

Eventually, discharges should offset it, but it would take like a month or more of flat new cases, I think, for the number of hospitalized patients to flatten. At that point you’re regionally very susceptible to outbreak.

Yep. I don’t know about looting as a direct result of this, but expiry of CARES + fear/panic → instability → unrest.

There is no way the regular people get more money unless there is an even bigger corporate slush fund created. Zero point zero.

So that’d be a no-no for unemployment, right?

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Do casinos and/or hospitality count under this metric? I’m pretty sure neither of those have been covered yet, and I don’t know how the government is going to ignore a 3 million person state that’s largely dependent on the gaming/hospitality economy regardless of how morally problematic it may be to them. If the governor of Nevada doesn’t shut the casinos down before the July 4 weekend (unless almost all recent numbers were due to testing), he’s leading the state into a Jim Jones massacre because he thinks no further help is coming.

I don’t think the casinos are getting shut dwon before the Fourth of July, and even if more help is coming from regular people (I think it is), it’s going to be accompanied by a shit ton more corporate handouts.

I also don’t think the help for regular people is coming on a timeline based on when regular people need it. It’s coming on a timeline dictated by a mister D. Jones.

Santa Clara county should already be shut down again, and we’re not.