{"id":48746,"date":"2020-06-27T03:21:01","date_gmt":"2020-06-27T03:21:01","guid":{"rendered":"https:\/\/virusreports.net\/virus-fatality-picture-is-obscured-by-ultimate-lagging-indicator\/"},"modified":"2020-06-27T03:21:01","modified_gmt":"2020-06-27T03:21:01","slug":"virus-fatality-picture-is-obscured-by-ultimate-lagging-indicator","status":"publish","type":"post","link":"http:\/\/virusreports.net\/virus-fatality-picture-is-obscured-by-ultimate-lagging-indicator\/","title":{"rendered":"Virus Fatality Picture Is Obscured by Ultimate Lagging Indicator"},"content":{"rendered":"
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The Trump administration has highlighted an apparent disconnect between rising cases and declining mortality as proof the Covid-19 pandemic is under control.<\/p>\n

\u201cFatalities are declining all across the country,\u201d Vice President Mike Pence<\/bsp.bb.link> said at a coronavirus task-force briefing in Washington on Friday. He called the rise in new cases in people under 35 \u201cvery encouraging news,\u201d saying they aren\u2019t as likely to die from Covid-19.<\/p>\n

However, the mismatch appears to be more an anomaly caused by quirks in how deaths data is collected and reported, along with a greater number of younger people catching the contagion, than a sign the coronavirus is becoming less lethal or easier to treat.<\/p>\n

Nationally, the death toll is rising by around 600 to 700 a day, even as record numbers of new cases were diagnosed this week. That\u2019s far below the height of the pandemic when more than 2,500 deaths were reported some days. Medical experts say it\u2019s too soon to know for sure that deaths are still declining.<\/p>\n

That disparity has health experts and the public asking questions: Is it because those getting sick now are younger than those who fell ill in March and April? Are we getting smarter about the use of ventilators? Are new drugs like Gilead Sciences Inc.’s remdesivir helping? Are cases milder because of warm weather?<\/p>\n

\u201cThe uncertainty right now is as high as it has ever been since the very scary early days in mid-March,\u201d said James Scott, a professor of data science at the University of Texas in Austin. He\u2019s part of a University of Texas modeling team that predicts that deaths will tick up in July.<\/p>\n

Complicating matters, there can be a weeks-long lag in many states between when someone dies and when that\u2019s included in the daily reports. That means deaths could be on the rise days before states say they are.<\/p>\n

It\u2019s not just the fatality statistics that can\u2019t be relied on completely: Basic information such as daily new Covid-19 related hospitalizations isn\u2019t reported by many states, among other key data points that could help scientists predict which direction the death tolls are heading.<\/p>\n

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Source: University of Pennsylvania<\/p>\n<\/p><\/div>\n<\/p><\/div>\n

\u201cWe have a very heterogeneous pandemic experiment right now — different parts of the country and different states are experiencing very different things,\u201d said Jeffery Morris, director of the division of biostatistics at the University of Pennsylvania\u2019s Perelman School of Medicine. \u201cIt is kind of a paradox.\u201d<\/p>\n

So while it\u2019s too early to see what the recent surge\u2019s death toll will be, if the exponential growth in cases continues unabated, increased deaths are all but inevitable.<\/p>\n

\u201cThis particular part of the epidemic is just taking off, and we\u2019re still on the runway,\u201d said Thomas Giordano, chief of infectious diseases at Baylor College of Medicine in Houston. \u201cThe last thing to happen is the death. We just aren\u2019t that far along with this one yet.\u201d<\/p>\n

Time Lag<\/strong><\/h3>\n

Deaths are the ultimate lagging indicator, especially with Covid-19. It takes several weeks after a diagnosis for a patient to die. Then it takes more time, sometimes weeks, for doctors to fill out death certificates and health officials to adjudicate the deaths. Only then are they finally added to the official state tally.<\/p>\n

\u201cYou can\u2019t look at deaths as an indicator of where the outbreak is at this particular period of time,\u201d said Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security. <\/p>\n

Waiting for data to roll in requires \u201cpatience that is hard to muster during a crisis,\u201d said Joe Gerald, an associate professor of public health policy and management at the University of Arizona. But \u201cif you want reliable, complete data, you have to wait for it, especially on deaths.\u201d<\/p>\n

In Arizona, the time between diagnosis and death from Covid-19 now is about 14 or 15 days, up from four or five days early in the pandemic. Then the state health department must verify the death, so there can be a three-plus week lag between a new case and a fatality being reported, Gerald said.<\/p>\n

Half of the deaths reported for the week ending June 14 were more than a week old, so he expects it to take at least another week before he can reach any conclusions about the mortality rate for this surge. A modest bump could be expected with younger patients being hospitalized at a higher rate of hospitalization, Gerald said.<\/p>\n

Younger Age<\/strong><\/h3>\n

Roughly 80% of deaths have been people 65 and older, according to data from the U.S. Centers for Disease Control and Prevention. Less than 10% have been under 45. That\u2019s led people like Pence to predict there won\u2019t be many deaths as the virus is now infecting more younger adults. <\/p>\n

In Florida, where reported cases shot up 7.8% Friday while deaths rose 1.2%, the median age of patients dropped to 37 in mid-June from over 60 in mid-March. Deaths have plateaued due to a \u201cdrastic shift in the age of people being infected,\u201d said Jill Roberts, an associate professor at the University of South Florida College of Public Health who specializes in emerging diseases. \u201cThe healthy people who are less likely to suffer severe consequences are accounting for the majority of cases.\u201d<\/p>\n

She blamed it in part on the crowds at reopened bars. \u201cInside, where nobody is wearing masks, where people are maybe yelling or screaming over music, all those things create the perfect scenario\u201d for viral spread.<\/p>\n

On Friday, the state banned drinking alcohol in bars.<\/p>\n

But if elderly people being more cautious and younger people less so drove down the average age of patients, it would generate fewer hospitalizations. So far, they\u2019re rising in Florida, suggesting this isn\u2019t the only thing going on.<\/p>\n

The big danger is that as more younger people get infected, it will spread to the elderly. That\u2019s especially true in Florida, where one in five residents are over 65. Did younger Floridians, with asymptomatic or pre-symptomatic cases, visit their parents or grandparents on Father\u2019s Day and infect them?<\/p>\n

\u201cMy biggest concern is what happens two weeks from now,\u201d Roberts said. \u201cIndividuals who are seeing spiking cases right now, they could infect other people. And if they infect other people, we\u2019re going to see hospitalizations and deaths follow.\u201d<\/p>\n

Improved Care<\/strong><\/h3>\n

Better treatments could also explain the gap. Remdesivir, approved on an emergency basis in May, helps hospitalized patients recover about four days faster. One study suggests it may also lower the death rate. It\u2019s now used in hospitals alongside convalescent plasma, a type of blood that\u2019s collected from survivors that may contain virus-fighting antibodies. And just this month, the steroid dexamethasone was shown to keep those on ventilators alive in a trial led by the University of Oxford.<\/p>\n

As doctors have learned more about the disease, they\u2019ve discovered better strategies. Severely ill patients have been found to benefit from being prone on their side or stomach.<\/p>\n

\u201cWe have learned best practices from around the world, and there\u2019s been a real global sharing around areas that have faced this epidemic in large portions and what they\u2019ve learned,\u201d said Bill McKeon, president and chief executive officer of Houston-based Texas Medical Center, which has seen its intensive-care unit beds fill up as cases rise.<\/p>\n

Milder Summer Cases or Weakened Virus<\/strong><\/h3>\n

There\u2019s also the possibility that cases may be getting milder, either due to changes in transmissibility in warmer weather, or changes in the virus itself. The warm weather theory holds that hot, humid temperatures cause viral particles to drop to the ground faster.<\/p>\n

Most of the attention has focused on whether the heat will reduce the total number of cases. But a subtler effect of weather may be that many patients are initially infected with a lower dose of the virus, leading to less severe symptoms, says David Rubin, director of PolicyLab at the Children\u2019s Hospital of Philadelphia.<\/p>\n

Some researchers also think Covid-19 may be getting less potent as it replicates. The hypothesis has gained wide attention since it was put forth by Italian doctors a few weeks ago, but the claims are highly controversial.<\/p>\n

The World Health Organization has disputed that the virus has mutated in any significant way.<\/p>\n

To contact the authors of this story:
<\/br>Robert Langreth<\/bsp.bb.link> in New York at rlangreth@bloomberg.net<\/a><\/p>\n

Emma Court<\/bsp.bb.link> in New York at ecourt1@bloomberg.net<\/a><\/p>\n

Michelle Cortez<\/bsp.bb.link> in New York at mcortez@bloomberg.net<\/a><\/p>\n

To contact the editor responsible for this story:
<\/br>Heather Smith<\/bsp.bb.link> at hsmith26@bloomberg.net<\/a><\/p>\n

Timothy Annett<\/p>\n

\u00a9 2020 Bloomberg L.P. All rights reserved. Used with permission.<\/p>\n<\/div>\n<\/div>\n<\/div>\n

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The Trump administration has highlighted an apparent disconnect between rising cases and declining mortality as proof the Covid-19 pandemic is under control.\u201cFatalities are declining all across the country,\u201d Vice President Mike Pence said at a coronavirus task-force briefing in Washington on Friday. He called the rise in new cases in people under 35 \u201cvery encouraging…<\/p>\n","protected":false},"author":1,"featured_media":48747,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"tdm_status":"","tdm_grid_status":"","footnotes":""},"categories":[24],"tags":[6491,71],"class_list":{"0":"post-48746","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health","8":"tag-fatality","9":"tag-virus"},"yoast_head":"\nVirus Fatality Picture Is Obscured by Ultimate Lagging Indicator - Virus Reports<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"http:\/\/virusreports.net\/virus-fatality-picture-is-obscured-by-ultimate-lagging-indicator\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Virus Fatality Picture Is Obscured by Ultimate Lagging Indicator - Virus Reports\" \/>\n<meta property=\"og:description\" content=\"The Trump administration has highlighted an apparent disconnect between rising cases and declining mortality as proof the Covid-19 pandemic is under control.\u201cFatalities are declining all across the country,\u201d Vice President Mike Pence said at a coronavirus task-force briefing in Washington on Friday. 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