The Homa Files

That’s the metric, not cases. that we should stay focused on.
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From the get-go I concluded that “confirmed cases” was a problematic metric (due to false positives, varying testing methods and confirmation criteria, and an uncertain mix of people being tested and their outcomes) …. and that our laser focus should be on “daily new deaths” which, while subject to some definitional variance, is a binary, countable number.

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

Somewhat contrary to my own advice, a couple of weeks ago, I started including the Case Fatality Rate (CFR%) in my morning COVID stats post.

Why is that “somewhat contrary to my own advice”?

Dividing a reasonably reliable number (deaths) by a potentially flakey number (cases) usually results in a potentially flakey “synthetic number” that might be misleading.   

There was a glaring upward trend in the CSR%.

Noting the upward trend in the CFR%, a couple of readers asked “Why? What’s going on?”

In a prior post, I took a stab at the answer:

The simple arithmetic answer to the question: The CFR% is going up because daily deaths have plateaued (i.e. stabilized at their peak level) … while confirmed cases have fallen sharply.

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While that’s true, it didn’t really answer “why?”, so I started looking at the component number that was exhibiting the greatest variance: confirmed cases.

Why did cases explode, spike and then start declining so steeply?

Were these movements real or just loud statistical noise?

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One hypothesis: testing levels were varying and impacting case counts.

Case counts are a function of the number of tests being done, so maybe more people were getting tested after the holidays … but, then the testing propensity fell off sharply with a commensurate drop in cases.

Among the possible reasons for a drop in testing: (1) Red states doing less testing to rationalize business & school openings (2) Blue states doing less testing to demonstrate a Biden “miracle” (3) Many states repurposing testing sites to vaccination sites

That hypothesis doesn’t appear to hold water: The level of testing bounces around a bit, but the fundamental trend is level.

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OK, so let’s test one of my original assertions: the case counts are just plain flakey.

I have greater statistical confidence in the reported number of people hospitalized … and that number should correlate with case counts, right?

Said differently, if those two series exhibit different patterns then I should be able to conclude that the case counts are just flakey, right?

Well, somewhat to my surprise, case counts and hospitalizations are tracking pretty closely.

That lends some credibility to the case counts.

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So, an obvious (but largely ignored) conclusion emerges as even more evident then before:

The systemic reason that the CFR% is increasing is that the death count has plateaued at a stubbornly high level (about 3,000 deaths per day).

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So, we’re re-centered on the pivotal question:

> Why isn’t the number of daily deaths dropping commensurate with the declining case counts and hospitalizations?

The easy “brush off” answer is that there’s a lag between cases being confirmed and deaths … and the death count will soon start declining, too.

My hunch: That may be, but there’s probably more to the story.

Perhaps, more of the confirmed cases are consequentially severe (i.e. not just minimally symptomatic or totally asymptomatic).

If true, that’s potentially a very big deal.

It would mean that the COVID death rate is creeping up.

That would be very bad news.

But, there’s compensating good news:

Based on their clinical trials, all of the vaccines (Pfizer, Moderna and soon-to-come J&J) cut to essentially zero  the likelihood of  getting hospitalized or dying from COVID.

Bottom line: Based on the numbers, GET VACCINATED!

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DISCLAIMER: I’m not a medical professional or scientist — just a curious, self-interested guy.  So, don’t take anything that I say or write as medical advice. Get that from your doctor!

This entry was posted on February 18, 2021 at 10:00 am and is filed under COVID - vaccine, COVID-19 Tracking. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.