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The post Amid record case counts, OHA asks Oregonians to reel in indoor gatherings appeared first on Virus Reports.
]]>PORTLAND, Ore — On Friday, state officials delivered something of a wakeup call to Oregonians who are letting their guards down at indoor parties and gatherings.
A behavior that, officials said, is exacerbating the spread of COVID-19 and contributing to record numbers of confirmed cases.
“We’re asking everyone in our state to voluntarily limit indoor social gatherings to fewer than 10 people for at least the next three weeks,” said Patrick Allen, director of the Oregon Health Authority.
The voluntary cap, announced during a media briefing via phone, would be a tightening of guidelines laid out in Phase 1 of Oregon’s re-opening plan, which allowed for social gatherings of up to 25.
The announcement came after case counts in Oregon repeatedly broke records this week.
The current record was set Thursday, with 389 new cases and six deaths in one day.
Officials said Friday, when counties began re-opening, they knew the virus would spread, but, they noted, it’s spreading more than it has to.
Allen said Oregonians are letting their guards down in social settings like “…graduations, birthdays, weddings, holidays like Memorial Day, Mother’s Day, Father’s Day, 4th of July,” he said. “We’ve seen outbreaks linked to exercise classes, fraternity parties, bachelor parties.”
Oregon’s state epidemiologist Dr. Dean Sidelinger noted restaurants, grocery stores and businesses that host the public are not being asked to limit groups inside to 10 people.
In short, he said, they’re not the problem.
“We have strong recommendations, strong guidance for business, and most businesses are following those,” he said
Dr. Sidelinger added, right now, state officials aren’t considering closing counties again.
That said, they want to get the problem under control fast.
While they can’t diagnose them all, the OHA estimates roughly 1,100 Oregonians are contracting COVID-19 each day.
The agency’s modeling shows, even if residents buckle down and slow the spread by 10%, officials expect that number to keep rising. Within the next month, they estimate, it would reach 1,600 new infections per day.
If nothing changes, they expect the number to climb to 3,600 new infections each day.
If things get worse and people mingle more, they estimate we’ll see 7,300 new infections per day.
At that rate, it wouldn’t take long for the infections to overwhelm our hospitals, like they are in Texas, Florida and Arizona.
While the rate of people surviving the virus is increasing, Dr. Sidelinger noted, COVID-19 is still dangerous and unpredictable.
”Yes, our healthcare system has gotten better at treating this disease and treating the complications of this disease and preventing deaths,” he said. “But there’s still a significant number of that and increasing deaths across the United States from this disease. There are still people who are discharged from the hospital who have ongoing complications.”
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]]>The post Death counts become the rhythm of the pandemic in the absence of national mourning appeared first on Virus Reports.
]]>This macabre ritual — searching for meaning in numbers that pulse up and down, day after day — is one countless Americans have adopted. Johns Hopkins University, the source of data for many popular covid tracking sites, is registering about 4 billion hits on its pandemic dashboard each day, presumably because many people are refreshing regularly. And the news is never good, only better or worse versions of awful, as the nation endures death at a pace rarely seen even during its most lethal public health disasters and most violent days of war.
Watchers of the daily death counts are looking for different things: Hints of the future, understanding of the past, a sense of scale, a sense of loss, a wisp of hope.
But as Memorial Day arrives, there have been few organized rituals of collective mourning aside from President Trump’s order to lower flags to half-staff in honor of nearly 100,000 covid-19 deaths. Daily reckonings with mortality counts, meanwhile, have become proxies for images of flag-draped coffins that have become the standard symbol for America’s tragedies.
“It’s not the best way to do it. It’s not that healthy,” said Dionne, an assistant professor at University of California Riverside. “The data give me a way of thinking about concerns I have for other people I care about… It’s a way for me to channel my concern because I can’t really do it another way.”
President Trump has sent military jets soaring through the skies above many U.S. cities, including New York, Atlanta and Washington, to celebrate the doctors, nurses and other medical personnel playing heroic roles in combating covid-19. But grieving has been done largely in isolation, or over Zoom or FaceTime. Emails have taken the place of hugs. Funerals have gone online to avoid spreading more disease.
Against this backdrop, the mounting national mortality counts have taken on unusual resonance, say those who follow them, as well as an unquestionably political character, fueling debates over who failed and how that will shape November’s elections. Trump and his allies have begun spinning conspiracy theories about the data being inflated, defying the judgment of epidemiologists and experts in mortality statistics, who say the current counts are almost certainly too low.
But as experts study these issues, the online death counters have become the Dow Jones tickers of the coronavirus, a way to keep track that’s bloodless, yet, for some, an experience that might be called micro-grief.
“I have a couple of them that I watch,” said bioethicist Kelly Hills, co-founder of Rogue Bioethics in Massachusetts. “It’s grim, and it’s soothing. It’s repetitive distancing, for lack of a better term… Everybody gets the same data point every day and filters it into their own lives.”
An imperfect tabulation
The death counts that appear hour after hour are the products of elaborate processes, as individual data points rise from thousands of sources across the country.
First, come the physicians who declare individual causes of death and report them to health departments, which have been posting state and local covid-19 mortality counts on publicly available websites. From there, the tallies are scraped, studied for anomalies and compiled by tracking sites, such as Johns Hopkins’ or the one The Washington Post publishes on its homepage, which for weeks has been among the most viewed features on The Post’s website.
Regular followers of this data long ago noticed the distinctive decline during weekends, when reporting is stalled or delayed as some offices close, then the rise in the early part of each new week — often peaking Wednesday or Thursday — before falling off again.
Some of the nation’s leading brains study these numbers for what they reveal about our ongoing public-health disaster. Epidemiologists look for hints of transmission dynamics. Demographers try to understand the scale of mortality. Political professionals look for data that can be weaponized in the coming campaigns.
For all of these purposes, the data from online trackers is imperfect. It often lags days behind actual deaths, weeks behind infections and even further behind the public policy decisions that may contribute to the spread or stifling of the novel coronavirus.
But nothing rivals death counts in their power to shape our understanding of catastrophic events.
“Mortality is a lagging indicator, and there are limits to what it can tell you,” said Andrew Noymer, an epidemiologist and demographer at the University of California Irvine. But “in some ways, it’s the truest indicator.”
Noymer routinely checks the coronavirus page on the statistics site Worldometer, which has seen its traffic surge in recent months according to a CNN report focusing on unanswered questions about its ownership and management. The Post received no response to requests for information from Worldometer.
Those craving their daily or hourly data fix have several options. Google offers covid-19 mortality data for those who type search queries on death counts. Many individuals and institutions tweet the numbers. News sites in many cases have their own trackers. City and county health departments across the nation have improved the access and transparency of this data, so most Americans can see how daily death rates are rising or falling in their own communities — or those of their friends or families.
But no matter the site, the overall picture is the same. The United States has more than double the number of reported covid-19 fatalities as any other nation, with the United Kingdom a distant second. The overall national count of confirmed cases, at over 1.6 million, is more than the combined totals of the next six nations — Russia, Spain, the United Kingdom, Brazil, Italy and France.
The covid-19 death toll, despite months of severe public restrictions to slow the virus’s spread, remains on track to exceed the U.S. death toll of the highly lethal flus of 1957 (116,000) and 1968 (100,000) while likely falling short of the 1918 flu pandemic, which killed an estimated 675,000 Americans and 50 million people worldwide in 1918 and 1919.
But Noymer, who uses his daily data fix to update what he calls a “mini model” of pandemic mortality, isn’t even sure about that when it comes to the United States. His current projected total: 1.4 million American dead through 2024 if the covid-19 death rate stays roughly the same.
“The 1918 flu is in the annals of history as one of the worst things to happen to human health,” said Noymer. “So when we’re in that territory, that’s pretty serious.”
Tara C. Smith, a Kent State University epidemiologist, tracks Worldometer and the Johns Hopkins site, using them to monitor covid-19 deaths. She has particular interest in variations by region and demographic groups and tracks the overall rise and fall of the pandemic.
“It’s slowing a little bit,” Smith said cautiously.
The gradual downward trend in deaths doesn’t keep Smith from worrying as she pores over the statistics. What she sees in her daily encounter with mortality data — and other metrics — is how far there still is to go in testing, in contact tracing, in the basic science of transmission.
If someone had told her in January that the world’s richest and mightiest nation would still be struggling with these public health basics four months later, she would have shaken her head.
“I would not have believed that,” Smith said.
But it’s all there, in the grim data that just keeps coming.
A morning ritual
For Dionne, who studies how politics compare across nations and whose own family spans the globe from California to Colorado to South Korea, regularly checks Twitter, the Johns Hopkins site, some news sites and also the Riverside County, Calif., health department, for the death toll in her own community.
Her full morning ritual can take 20 or 30 minutes, while her partner and children are still sleeping. This kaleidoscope of data also helps Dionne’s mind, even though it is trained in statistics, to grapple with the human scale of tragedy.
One cousin, whose hacking cough and red, weary eyes were early signs of severe illness coming on, already has survived covid-19. But what is the risk to Dionne’s retired mother and stepfather in suburban Las Vegas, where daily deaths have fallen but communities are rapidly reopening, risking a second wave? What about her cousins in Seoul? And, on a professional level, what’s going on in African nations, such as Malawi, that Dionne has studied with particular interest? Is that outbreak she’s heard about among truck drivers in Tanzania showing up in official statistics yet?
But feeding Dionne’s mind goes only so far. When a university colleague mentioned in an email that her father had just died of covid-19, the news shook her. In a subsequent exchange online, the colleague shared pictures of her late father just weeks earlier, at Easter. He was 94 but still appeared strong.
Dionne was glad to share the grief, to make a connection, but it also felt inadequate.
“For me, I feel like the people who are being lost, we’re not bearing witness to that,” she said.
Soon after, her colleague’s father appeared to Dionne again — as one more anonymous data point on her iPhone during her restless daily encounter with death.
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]]>The post Coronavirus Case Counts And Death Tolls Are Likely Undercounts : Goats and Soda appeared first on Virus Reports.
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A COVID-19 testing operation stays busy in Boyle Heights, Calif. Daily case counts overall may be on the low side because access to testing is limited in some parts of the world.
Brian van der Brug/Los Angeles Times via Getty Images
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Brian van der Brug/Los Angeles Times via Getty Images
A COVID-19 testing operation stays busy in Boyle Heights, Calif. Daily case counts overall may be on the low side because access to testing is limited in some parts of the world.
Brian van der Brug/Los Angeles Times via Getty Images
The U.S. has the most coronavirus deaths of any country in the world — on May 11, the death toll passed 80,000.
And that’s likely an undercount.
“Almost certainly it’s higher,” said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, at a virtual Senate hearing on Tuesday. “There may have been people who died at home who were not counted as COVID because they never really got to the hospital.”
It’s not just the death toll that’s likely higher. Medical statisticians say we have been undercounting cases since the pandemic started — not only in the U.S. but also around the world. That’s because in countries rich and poor and in between, people who contract COVID-19 are not necessarily diagnosed — because of the shortage of tests and the difficulty of getting tested in some parts of the world, especially remote spots.
So you should keep in mind certain caveats as you consider the endless stream of numbers.
Here’s what we know about some of the most frequently discussed data points.
Total confirmed cases
What we want this to tell us: How many people have had COVID-19.
What it actually tells us: How many people have tested positive for the live virus (the most common way of being diagnosed) or, in some cases, been diagnosed based on symptoms. The actual number of people who have had COVID-19 is probably higher.
Caveats:
- Access to testing is limited in many parts of the world, so not everyone with COVID-19 symptoms is confirmed and counted.
- Official counts of “confirmed cases” miss people with no symptoms or mild symptoms who may not seek testing or medical care.
- The swab tests are considered to be generally reliable but aren’t fail-safe. There’s a margin of error from mistakes in sampling or lab processing techniques as well as from faulty tests.
Daily case counts
What we want this to tell us: Is the number of new cases of COVID-19 rising or falling over time?
What it tells us: How many cases are reported on each day and how that number compares with previous days. Only in areas where large numbers of people are tested regularly could the curve of daily case counts be considered a reliable marker of spread or containment.
Caveats:
- Testing delays and backlogs in many countries means that a case may be reported days or weeks after a sample was taken. It can also take a few days for a confirmed case to be reported to national and global health authorities. So the number of new cases reported on a specific date may reflect both new and recent cases rather than the new case count on one specific date.
- Countries don’t always use the same definition for “confirmed cases,” and some have changed their criteria as the pandemic has evolved. On April 14, the U.S. Centers for Disease Control and Prevention began including people presumed to have COVID-19 based on symptoms in their daily tally of confirmed cases even if the individuals had not been tested. China has revised its case definitions for infected people multiple times, briefly including diagnosis by symptoms in one province, then returning to a requirement for a lab test to confirm.
Total deaths
What we want this to tell us: How many people have died from COVID-19 from the start of the outbreak until now.
What it tells us: How many people have died with the official cause of death listed as “COVID-19” — excluding those who died of the disease but were not identified as COVID-19 casualties. These numbers generally represent a conservative count of deaths and will likely be revised upward on review. But they are probably more accurate than case counts. “The [under]reporting issue for death numbers is less severe than case numbers, but it still exists,” says Sen Pei, a public health research scientist at Columbia University.
Caveats:
- As with testing, issues with varying definitions and delays in reporting also apply to deaths. In Wuhan, China, for example, where the first COVID-19 cases were discovered, the death tally jumped by 50% overnight in mid-April. WHO says this is because a review of past records found 1,290 deaths had been missed in the official count because of patients dying at home, medical staff too busy to fill out paperwork at the time and incomplete reporting from field hospitals.
Death rate for coronavirus patients
What we want this to tell us: How likely are people who get COVID-19 to die from it?
What it tells us: The total number of reported deaths divided by the total number of confirmed cases — both of which could be undercounts.
Caveats:
- In the middle of an epidemic, the death rate changes day by day based on the number of reported cases and deaths. Death rates could decrease over time as more survivors are identified.
- It’s difficult to meaningfully compare death rates across countries because of variable factors including the extent of testing and the demographics of the population (countries like Italy, which have a greater proportion of older people, have seen high death rates).
Recovery rate for coronavirus patients
What we want this to tell us: How many people who have contracted COVID-19 recover.
What it tells us: How many people who have been officially diagnosed with COVID-19 have kicked the virus.
Caveats:
- The number of confirmed cases may be missing many people with mild cases, who tend to recover — so the total count of recovered people is probably higher.
- The definition of a recovered case varies. The World Health Organization states there should be two negative tests at least 24 hours apart while the Centers for Disease Control and Prevention also offers a symptom-based definition in places where tests are not readily available. Neither definition takes into account long-term physical and mental health effects, such as reduced lung function from scarring or memory issues from treatment drugs, especially in people who have recovered from severe cases.
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