From “flattening the curve” to “learning curves”…

A conceptual rationale for why COVID cases are surging but deaths aren’t.
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All along I’ve been arguing that the truest and most relevant measure of COVID-fighting is the death rate.

MUST READ: How will we know when we’ve turned the COVID-19 corner?

And, I’ve recently been showcasing the relationship between confirmed cases and deaths.

See: Where’s the case-related spike in deaths?

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The data says: Since mid-April, the number of daily confirmed cases has more than doubled, but the number of daily new reported deaths has apparently stabilized at about half of mid-April levels.

How can that be?

Here’s a way of thinking about the how & why…

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From the get-go, we’ve been told that we need to “flatten the curve” by taking mitigation actions ranging from lock-downs to social distancing, masks and hand-washing.

The effect was to spread deaths out until an effective therapy or vaccine was launched.

For details see: Does “flattening the curve” really save lives?

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In aggregate, the results are largely consistent with the theory: Daily deaths peaked, then slowed … and now appear to have stabilized between 500 and 1,000 deaths each day.

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But, again, the number of confirmed cases has more than doubled.

Why the disconnect between confirmed cases and reported deaths?

Some hypotheses: more testing, changed demographics (more younger cases), more effective treatment protocols.

All are probably true to some extent.

So, let’s bundle them as “learnings” … repurpose the “flattening curve” … and start thinking “learning curves”.

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My take: This conceptual representation largely illustrates what’s going on these days.

Early-on, deaths were concentrated along the northern Atlantic coast:  New York, New Jersey, Connecticut, Rhode Island and Massachusetts.

Now, new deaths are concentrated along the Sun Belt s states: Florida, Texas, Arizona. California.

These later virus-developing states are testing more and, thus, counting more mild COVID cases … and, more importantly, benefiting from the learning in the early developing states.

For example, hospitals and doctors are reportedly:

  • Isolating “vulnerables” more stringently and prioritizing them for care when they get infected.
  • Treating cases more aggressively on the front-end with anti-inflammatory steroids and  drugs
  • Modifying protocols for ventilator use (i.e. clearly recasting them as a last resort)

So, average hospital stays are reportedly shortened by as much as half … and mortality rates are down.

It’s called a “learning effect” … and helps explain why C-19 confirmed cases and reported daily deaths seem to be disconnected.

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