Vox’s Dylan Scott notes that we just broke the April peak COVID hospitalization count:
The curves… are not good.
More people in the US are hospitalized with Covid-19 than ever before:https://t.co/54COQaw92t
with @elizabarclay pic.twitter.com/iluTfnwoiT
— Dylan Scott (@dylanlscott) July 23, 2020
The big difference between now and then is that the hospitalizations are more spread out geographically today than in April. There are local and regional systems that are hitting ICU capacity constraints, but there is still the ability to shift people to within region hospitals.
However, the thing we need to note is that hospitalizations significantly lag infections. Today’s hospitalizations are the result of infections in mid to late June and early July.
We should also note that the April peak had a fast ascent and a very slow descent. Once someone is in the hospital for COVID, they stay in the hospital for a while. Discharges are slow so using social distancing and mobility restrictions to curbstomp infection spread to reduce inflow is critical. However our daily case count is still increasing.
Someone who is reported as infected today is highly unlikely to be hospitalized today (this is different than it was in NYC in late March where the only testing that was happening was for the obviously and seriously ill). Instead, a person infected today has a probability of needing hospitalization in the future that will vary by time, location, and personal characteristics. July 17, 2020 reported almost 75,000 new cases, July 22, 2020 reported almost 72,000 cases. A significant number of people from those two days will need a hospital bed at some point. Almost none of that fraction is currently in the hospital.
As long as we have uncontrolled spread, we’re going to stress and potentially overwhelm our hospital systems even if that spread is more common in lower risk populations today than it was in March and April.
Jeffro
We are in for a bad two months, even if everyone in TX and FL and elsewhere got their shit together today.
Not holding my breath.
Let me put it this way to America’s K-12 school parents: we can’t open the schools for ‘regular’ school until we’ve had a nationwide lockdown for eight weeks (and even then, some hotspots won’t be able to open). So…whenever you’re ready to quit bitching, or trying to form ‘pandemic pods’ for your rugrats, and are ready to beat on your elected officials instead…we can start that countdown.
Ready…set…go?
JPL
@Jeffro: Well Rand Paul was hoping that we would reach herd mentality. fkfkffkkfkfkfk
Calouste
Also, because treatments have improved and patients are younger than they were in the early stages of the pandemic, they are less likely to die and more likely to stay in the hospital longer than a few months ago.
The Thin Black Duke
It’s nothing a payroll tax cut can’t fix.
bbleh
Obviously, then, the thing to do is get angry, blame the data collectors and the media for trying to undermine America’s resolve, and insist that we get kids back in schools and people back to work!
Oh, and cause a few riots on the side, just for general entertainment.
dmsilev
Sigh.
I guess a scintilla of good news is that at least some of the currently-worst-hit states look to be peaking. Arizona is seeing their hospitalization numbers go down; not a huge amount, but enough to be noticeable. Florida, on the other hand, not so much.
Another scintilla of good news is that the death rate really does seem to be lower now than in the spring. Set the two y axes of that widget to “Currently hospitalized” and “Daily deaths”. In the spring, both peaked about the same time. Now, even though deaths are definitely increasing, the rate is significantly lower than it was in April and there’s also a real time lag between the two. So, even as people are going to the hospital, they’re surviving at greater rates and the ones who do die are lasting longer. Says that, not surprisingly, doctors are getting better at treating the disease. It’s still nasty, especially given the long-term damage that a lot of survivors are reporting, but any bit of progress is worth celebrating.
WaterGirl
@dmsilev: is lasting longer before you die a plus?
White & Gold Purgatorian
Well, we finally got local mask or ordinances here (north Alabama) last week and they announced this week that school will be online only for the first 9 weeks. These are good moves and I’m glad officials are taking the actions now, but very frustrated and angry that they created the conditions that led to this spike. Just last week the local mayor was all about “hopeful” and “optimistic” that things would start moving in the right direction, while also saying any further shutdowns were completely off the table. I’m pretty sure he was one of those “hope is not a plan” assholes a few years ago, but now that he’s faced with the hard decisions, empty hopes are all he puts forward. Total abdication of responsibility.
JPL
hahahahahah trump canceling his convention in order to protect people from the china virus and the radical left mob.
Doug R
@WaterGirl:
Cancer survivors take 7 years as having survived, each day above ground is a plus.
dmsilev
@WaterGirl: Maybe not for the poor folks on the ventilator for a week rather than 3 days before succumbing, but in the aggregate, yes, because it means the medical community is getting better at getting people through this.
dmsilev
@JPL: Radical left-wing Jacksonville?
Benw
@JPL: Hahaha anti-fa stopped a fascist rally!
Baud
@JPL: In other words, not enough people were going to attend.
Benw
I just got halfway to the local grocery store and realized I forgot my mask! Briefly considered the tshirt over the face, but that’s a dick move. I think that’s the first time I’ve left the house without one since March!
bbleh
@JPL: Oh my that’s worth a drink!
dmsilev
@Baud: I mean, who could possibly turn down an invitation to spend five hours in an outdoor stadium in August in Jacksonville to hear Trump once again tell the story of how he aced the “does he have Alzheimer’s?” test.
JPL
@WaterGirl: This was an interview John Berman did on CNN… I sent it on because although most younger folks dont’ react this way, they can. I have no idea how long it will take this gal to recover..
link
JPL
@dmsilev: Well the NC meetings will still go on.
Martin
At the start of this, fatalities trailed infections by about 3 weeks. That should be a bit longer because doctors have gotten better at treating patients, however, it’s negative cycle in that longer survival means hospitals fill faster and exceptional measure kick in sooner (denying care to people because you’re out of resources). We didn’t add nearly enough capacity to stay ahead of this.
So, my guess is that fatalities will be slower to ramp up than infections for a few weeks and then it’ll turn sharper than the infection curve as hospitals max out.
Omnes Omnibus
@WaterGirl: Incremental progress is progress.
Baud
@WaterGirl:
It’s worked for me so far.
Dorothy A. Winsor
@Benw: I put an extra mask in my car for that very reason.
Enhanced Voting Techniques
@JPL: Herd immunity won’t stop it, just slows the rate of infection down. EU and NY still have people getting ill and dying, just in lower numbers.
Dorothy A. Winsor
So too dangerous for the convention, but schools should open or have their funding sent to religious and private schools. I hate these people so much, it’s not healthy.
ETA: Maybe the funding can go to Barron’s school.
?BillinGlendaleCA
Madame texted me that Glendale has decided to put some teeth in their mandatory mask order, which as been in effect since April, they’re going to start issuing tickets for non-compliance.
ETA: And cancelling the Republican convention, HAHAHAHAHAHAHAHA!
JPL
@Enhanced Voting Techniques: no kidding.. Even if we locked down our borders for weeks, it would still be around.
They need to just lock down Congress until after a new president is in office. this one sucks. Not the house.. the House of Reps. is fine.
dmsilev
@?BillinGlendaleCA: Is that just for stores and restaurants and so forth, or does it include “walking down the sidewalk”?
dmsilev
TPM:
Their convention is only about four weeks away. Good to know that planners have converged on a detailed gameplan of “a very nice something”. I’m sure that will work out fine for them.
Origuy
Indiana makes wearing masks mandatory.
It will be a Class-B misdemeanor, although the governor says the police won’t be patrolling for people without masks.
Ken
So more detail than their COVID plans of “it’ll just disappear” and “get numb to it”.
JPL
@Origuy: wow
NotMax
GOP ‘logical’ progression?
If we shut down testing, case reporting numbers will go down.
If we shut down hospitals, case admission numbers will go down.
// // //
trollhattan
The US has managed to exceed 1% of our population with confirmed infections. Foam #1 fingers for everybody. How many more undiagnosed? 1%, 2%, 4%?
New cases in our CA county are thankfully, bending downward after a troubling spike two weeks ago, although the data report is a few days behind and one wonders if the jump in demand for testing is affecting total diagnoses.
84.7% of our deaths are 65+ age group.
12.1% of total cases are 65+ age group; 18-49 comprise 61.3%.
.
trollhattan
@Origuy:
Since it’s Indiana, will a full hood with eyeholes qualify as a mask?
Asking for a friend.
NotMax
@dmsilev
The vention part may be put on ice but the con proceeds uninterrupted.
:)
noncarborundum
@Ken: More on the lines of the beautiful Republican health care plan that will cover more things than ObamaCare for a lot less money. They’re on the cusp of delivering that, any moment now.
West of the Rockies
“A very nice something…”
So, maybe weenies and beans in a shuttered Kmart parking lot with a local White Snake cover band?
Frankensteinbeck
@Enhanced Voting Techniques:
Mainly because only a tiny fraction of the population have had the disease, even in places like New York. One thing that this pandemic has driven home to me is that available hospital resources take it for granted that only a fly speck portion of the population need serious care at any one time. If even 1% of the population had the disease at one time. If the 1% confirmed cases were all sick right now, our hospitals would be drowned and in ‘dig mass graves’ mode. And that’s true even in countries whose health care system isn’t fucked like the US’s.
Benw
@Dorothy A. Winsor: galaxy brain!
misterpuff
Question: I wear a mask at all times in public (almost). Mask at work, mask at store, mask outside of my apartment, in parking garage until I get in my car. Then mask comes off. Thing is I have a convertible, once I’m on the street with top down, mask comes off. What is my risk factor for open air driving (or driving maskless with windows down)?
NotMax
@misterpuff
Exceedingly small.
Unless you live on the planet Gideon.
;)
misterpuff
@NotMax: I don’t have a convertible Enterprise.
Kent
Neither OR nor WA is spiking like CA or the south, although numbers are creeping upwards. On NPR this morning they were reporting that health officials in both states were saying that some test results were being delayed between one and two weeks up here. So that is potentially hugely troubling.
Kent
I think there probably is some sort of low-hang-fruit phenomenon going on though. In every population you will find a range of susceptibility to the disease based on both biology and behavior. You can probably rank everyone from 1 to 100 based on how susceptible they are to catching Covid. Those with low resistance or compromised immune systems would rank highly as would those who’s behavior puts them at risk, either voluntarily (party animals), or involuntarily (nurses). I think also that many of the so-called super-spreaders probably overlap with one or both of these categories. By contrast, there are a lot of people who just have naturally good immune systems and/or who naturally live isolated lives who are both unlikely to get the disease and unlikely to spread it.
I expect that when the virus sweeps through a place like NYC it is going to spread first to the low hanging fruit, so to speak. All those 90-100 rated individuals who are most highly susceptible through biology or behavior. If the virus returns months later, even though herd immunity hasn’t yet been acquired, if all the low hanging fruit has already had the disease and is largely immune then it will be much harder for it so spread if all those super spreaders are off the table.
We haven’t yet really seen any place where it has peaked twice in the same location. Even here in WA where there are two peaks that isn’t the case. The first peak was Puget Sound in the three counties around Seattle. The second peak happening now is the central and eastern WA counties around Yakima and the Tri Cities where all the industrial fruit and meat packing plants are. It only looks like two spikes when you look at the state-wide data but no single county has seen two spikes.
Jinchi
That’s probably why the mortality rate in NYC was higher than it is today.