Archive for the ‘COVID-19 Tracking’ Category
September 24, 2021
In yesterday’s post, we squeezed some data from Israel’s Dept. of Health.
Analyzing that data, we concluded:
> Vaccinated patients accounted for almost 65% of Israeli covid deaths in August
> But, the death rate among the unvaccinateds (181.7 covid deaths per million unvaccinated adults) was more than double that of the vaccinateds (81 covid deaths per million among vaccinated adults)
> So, the implied effectiveness of the vaccine (protecting against death from covid) was 55%
OK, let’s move the ball forward…
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The case for boosters
Let’s assume that our analysis of the Israeli data is correct and the implied death prevention effectiveness rate of the Pfizer vaccine has, in fact, waned down to 55%.
Question: What if the vaccinated Israelis had all gotten 3rd shots that boosted their protection back up to, say 90%?
From yesterday’s analysis, we concluded that the monthly death rate among unvaccinated Israelis (in August) was 181.7.
So, at a 90% effectiveness rate — if all were boosted — we would only expect 18 deaths per million vaccinated people (1 – 90% = 10% of the unvaccinated rate).
At that rate, about 300 of the 389 vaccinated deaths would have been saved (18 deaths per million x 4.8 million boosted vaccinateds= 86.4; 389 – 86.4 = 302.6).
That’s about a 75% reduction in vaccinateds deaths… and about a halving of the total death count (218 + 389 = 607; 302.6 / 607 = 49.8)
Those are pretty compelling numbers in favor of booster shots…
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But, Pfizer’s numbers differ
Here’s an interesting twist to the story…
In Pfizer’s booster application, the company presented data indicating that the efficacy of its vaccine only waned slightly
Specifically, Pfizer claimed that it’s vaccine’s effectiveness against hospitalization (and, presumably, death) declines from 96.2% percent at seven days after dose 2 to 90.1% two months later to 83.7% six months later.
Source
Stating the obvious: 83.7% is a high level of effectiveness … and much higher than 55%.
Think about that for a minute, though…
Based on Pfizer’s data, the vaccine is highly effective preventing hospitalization and that effectiveness does not wane very much over 6 months.
So, presuming that the grand objective is prevention of hospitalization and deaths, Pfizer’s data seems to weaken its case for booster shots.
Sure, it’s always better to have more immunization than less … but, is a boost from 84% to 90% statistically or operationally significant? Is it worth the cost and incumbent risks?
Hmm.
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CAUTION
Don’t draw any hard conclusions yet!
There’s much more to the story that we’ll get into next week.
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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!
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Thanks to DF for pointing me to the Pfizer data
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September 23, 2021
Let’s put it to a test, estimating vaccine effectiveness on some real life data …
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In yesterday’s post, we channeled Dr, Marty Makary’s conclusion that “The CDC has failed in its primary function to deliver data to guide our pandemic response.”
Often, the CDC has relied on data from Israel.
Israel was one of the first countries to start vaccinating … and is doing the best job, by far, of systematically gathering, analyzing and reporting vital data that can be squeezed to draw clarifying conclusions.
For example, below is a chart that Israel’s Dept. of Health recently released.
The key summary statistic: Vaccinated people accounted for 64% of Israeli Covid deaths in August.
Is that good news or bad news?
Specifically, what do the numbers say about the efficacy of the vaccines? Good or bad?
Take a minute, think about those questions … and maybe, crunch a few numbers before reading further
(more…)
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September 22, 2021
Johns Hopkins Dr. Marty Makary’s recent WSJ opinion piece struck a chord with me.
Paraphrasing his basic point:
The CDC has failed in its primary function to deliver data to guide our pandemic response.
Remarkably, the CDC, an agency with 21,000 employees, does not have much of a rapid response team.
Though the CDC is a very large organization, staffed with thousands of trained researchers … it most often just reacts to data from other countries (usually Israel) and regurgitates ad hoc observational studies with questionable scientific rigor (from places like Kentucky and Cape Cod).
Makary asks: Why isn’t the CDC producing (and reporting) the research that policy-makers (and the public) need for decision-making?
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My take: 20 months since the onset of the pandemic, “the science” is far behind the learning curve and hasn’t even developed what consultant’s call a “coherent theory of the case”.
Individual pieces of the puzzle seem to change shape based on the latest research study … from who knows where … done by who knows who.
And, there doesn’t seem to be much thought given to how the pieces fit together.
So, it’s not surprising that the research plan — if there is one — seems haphazard and incomplete.
Save for the near-miraculous vaccine development, we don’t seem to know much more than we did when the pandemic first hit.
And, taking the booster indecisiveness as an example, we don’t even have a clear picture of how the vaccines should be deployed, e.g. Should people with natural immunity be vaccinated? is it better to have more people partially vaccinated or those already vaccinated “boosted”?
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Makary concludes: “The CDC’s failure to report meaningful data has left policy makers and the public flying blind.”
Thankfully, Israel has its act together re: data collection and analysis … so the CDC has something to work with.
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For the record:
> The CDC has 21,000 employees and a $15 billion annual budget.
> It has data on more than 40 million Americans who have tested positive for Covid and 200 million who have been vaccinated.
> The data include the vaccine type, dosing schedule and vaccination date.
But, somebody has to turn the data into actionable information.
The CDC isn’t doing it…
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September 9, 2021
Recently, like many (most?) Americans, I haven’t been paying particularly close attention to the COVID stats.
So, I thought it was time to take a look…
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Vaccinations
There have been incremental gains since I last looked:
> 78% of those 18 and over have have gotten at least 1-shot … up about 10 percentage points since July 4
> 92% of Seniors have have gotten at least 1-shot … that’s essentially all Seniors when you consider naturally immune and medically disqualified
> 55% of teenagers (12 to 18) … that’s almost 14 million of them
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Deaths
We’ve consistently touted the death count as the truest measure on COVID’s impact.
The current 7-day average is 1,128
> That’s about 4.5 times the July 4 low point (255) … which is coincidentally, about the level 0f in-season flu deaths in a typical year.
> But, the current rate (1,128) appears to be peaking … and, it’s about 70% lower than the all-time COVID peak on Jan 16 (3,515)
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ICU Capacity & Utilization
Currently, according to JHU, there are approximately 85,000 ICU beds.
Source: JHU
Of 85,000 ICU beds, about 66,000 (79%) are currently occupied.
Of the 66,000 currently occupied ICU beds, about 25,000 (38%) are occupied by COVID patients… the other 42,000 are occupied by non-COVID patients.
The 25,000 ICU beds currently occupied by COVID patients are 15% below the all-time COVID peak (Jan. 17, 29,000 beds)
But, current COVID case rates (150,733 per day) are 40% lower than the Jan.12 peak (254,358) … indicating that a higher percentage of cases are requiring hospitalization. (15% versus 11%).
That said, that’s bad, but …
The CFR (case to fatality ratio) is currently .7% … roughly 1/2 of the January peak CFR (1.3%).
So, that’s where we are….
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July 29, 2021
Since Team Biden seems to have its collective hair on fire, I thought it would be good to put things in context by looking at the data …
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From the jump, we’ve argued that the most reliable Covid metric is the death rate.
The COVID death rate is now below the average number of flu-related deaths during the flu season… and far down from past peaks.
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Vaccination rates stalled at 500,000 per day, down from 4 million per day at the peak.
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Over 90% of vulnerable seniors have been vaccinated; over 70% of people 18 and over have gotten at least one shot.
Over 10 million teens (42%) have been vaccinated.
Draw your own conclusions re: whether it’s time to hit the panic button.
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July 16, 2021
We haven’t checked the numbers in awhile, so…
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Vaccinations
Close to Biden’s original goal of 70% of adults … almost 90% of seniors (over 65) … almost 40% of teenagers (just under 10 million).
Central question: What’s the upward limit in vaccine compliance?
WSJ: “With each day, as more Americans are vaccinated, an unvaccinated person’s likelihood of encountering the disease or spreading it goes down, as does his incentive to accept the risk of vaccination. ”
Especially given recent trends in Covid death rates…
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Covid-related deaths
The covid death rate continues to hover around 250 … roughly the in-season death rate associated with the flu … and down 66% from a month ago; down 66% from 3 months ago; and down 92% from the mid-January peak.
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Covid cases
The confirmed case count has turned up from its trough … roughly double what it was a month ago … worth closely watching, but not hair-on-fire time.
Keep in mind that the current rate is still down 66% from 3 months ago … and down 89% from the mid-January peak.
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Bottom line: Farther along than most people imagined possible, but not out of the woods yet…
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July 7, 2021
COVID death rate is now below the average number of flu-related deaths during the flu season.
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Vaccination rates stalled at 1 million per day, down from 4 million per day at the peak, but…
Almost 90% of vulnerable seniors have been vaccinated; over 2/3’s of people 18 and over.
9 million teens (37%) have been vaccinated.
On balance, it looks like we’re in pretty good shape…
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June 9, 2021
Life is heading back to normal regardless.
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Biden-Fauci promised that we could have small family BBQs on July 4 if 70% of adults get at least their 1st shot of a vaccine.
It’s looking like we’ll fall short of Biden’s goal.
But, not to worry.
If you’ve been out recently, you’ve probably noticed that many (most?) folks don’t care what Biden & Fauci have to say any more.
Americans are responsibly easing back into life and guess what: case counts are dropping and covid deaths are dropping (albeit, slowly).
That’s an entirely rational approach since…
> There’s no magic number re: herd immunity or its close cousin: adult vaccinations.
There’s no specific herd immunity threshold.
Best evidence is Fauci’s constant rising of the herd immunity requirement from 60% to 70% to 80% to 85% to whatever he’s pitching on MSNBC today.
Said differently, there’s no covid on-off switch set at 70% vaccinations.
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And, vaccination rates are only part of the story…
> The political-scientists still refuse to acknowledge that the vast majority of covid survivors have developed protective antibodies.
Some number of unvaccinated people fall into that category.
The implication: Some 80% to 85% of American adults are immune to the virus: More than 64% have received at least one vaccine dose and, of those who haven’t, roughly half have natural immunity from prior infection. Source
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> Transmissibility is not fixed: It can vary based on a population’s behavior, demographics and health.
We’ve seen this in action with Covid-19, which has spread far more quickly in some populations, as a result of differences in disease-mitigation efforts, housing density, age, occupations and both community and individual health conditions. Source
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> More specifically, transmissibility is, in the final analysis, a local dynamic.
A national vaccination rate may be an interesting barometer, but it’s not determining.
Said differently, some communities will likely reach the herd immunity threshold, even if the entire United States does not. Source
Conditions in New York and New Jersey have little impact on, say, Wyoming.
Viral spread in dense urban areas has little relevance to sparsely populated rural areas.
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The bottom line: Don’t fret over Biden & Fauci’s faux thresholds.
Pay attention to conditions in your local community.
If the number of hospitalizations and covid deaths keep declining … then get on with getting on.
DISCLAIMER: I’m neither a medical professional nor a 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!
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June 8, 2021
With an 86% vaccination rate, shouldn’t fatalities be closer to zero?
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I still think that the covid death rate, while itself a bit fuzzy, is still the cleanest covid severity metric.
So, I’m trying to understand why covid death rates — which have dropped from pandemic highs — are stubbornly hovering near 600 per day.
Who’s dying?
One might expect them to be relatively young and unvaccinated.
Certainly not vax-prioritized seniors, right?
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Let’s look at some data…
The CDC doesn’t report the demographics of daily new covid deaths … or, at least, I can’t find it.
So, I’ve tried to decompose the cumulative data that is reported…
Below is data for February 2021 (about 6 weeks into the vax rollout) and May 2021 (the most current) … and, calculated data for the period between those 2 dates.
Cumulatively since the start of the pandemic, the 65 & over cohort accounted for around 80% of covid-related fatalities.
OK, that’s not new news.
Most notably, the senior cohort has still been accounting for a 75% share of covid deaths over the past couple of months.
Said bluntly, the vast majority of covid deaths are still among those 65 & over.
What’s going on?
Are all of these deaths are coming from the 14% of seniors (roughly 8 million) who haven’t been vaccinated?
Or, are the vaccines’ effectiveness rates being overstated — and not preventing 90% of fatalities, as promised?
Hmm.
Something just doesn’t smell right…
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I wish the CDC, et. al,, would start reporting more meaningful data.
Case in point: I’d like to see daily covid deaths broken down by age (seniors young adults, teens, kids) … and by their vaccination status.
But, as usual, I won’t hold my breath.
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June 3, 2021
Now that the Memorial Day holiday is in the books and data reporting seems to have caught up…
> Daily confirmed case counts below 20,000; deaths still hovering around 600 per day.
Implication: The CFR (case fatality rate) has soared to around 4% (chart below) … why?
> Vaccination rate still falling despite … and that number is buoyed by teenage vaccinations (now over 6 million)
Note: about 13 million adults over 18 need to get 1st shots to hit Biden’s target of 70% by July 4
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May 28, 2021
A common hypothesis is that there’s a strong correlation between death rates and the percentage of a state’s population that that is vaccinated.
The hypothesis seems reasonable, so I decided to to test it…
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Below is a scatter chart of the 50 states … on the horizontal axis is the current vaccination rate (% of residents 18 and over who have received at least 1 shot) on the vertical axis is the past month’s covid death rate (deaths per million residents).
To the naked eye, the chart is more buckshot than correlation.
Arguably, there’s a slight positive relationship … with emphasis on “slight” since the R-squared is a mere .0325 … which is, for all practical purposes, not statistically different from zero.
Let’s dig a little deeper…
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Below is a matrix that puts names names on the above dots.
The rows are vaccination rates — over 60% at the top (good), under 40% at the bottom (bad).
The columns are the past month’s covid death rates — left is under 40 deaths per million (good), right is over 0 deaths per million (bad).
So, for example, the states in the blue quadrant have high vaccination rates and low death rates.
The states in the red quadrant have low vaccination rates and high death rates.
Those are to be expected.
But, there are a lot of states in the orange (high death rates despite high vax rates) and yellow quadrants (low death rates despite low vax rates)
click for a full-size, printable PDF
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Let’s look at the top rows … the states that have vaccinated the highest percentages of their residents.
A couple of observations:
> Nearly all of the states in the top 2 rows (high vaccination rates) are Northern Blue states … most with dense metro population centers.
> A majority of these high vaccination rate states still have high death rates … and, in aggregate, these states account for a disproportionate share of current covid deaths.
See Nums: 10 states account for 2/3′;s of covid deaths
> Most of the current high death rate states have had high death rates from the get-go … vaccinations may have cut the death rate from previously high levels, but the states are still challenged.
> Two states — Massachusetts & California — have currently low death rates substantially below their pre-vax levels … likely attributable to vaccinations, but there may be other factors in play.
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What about the bottom rows – the low vaccination rate states?
> Generally, states with low vax rates are Red states with dispersed populations … more rural … with many in sunnier Southern climates.
> Michigan and Wisconsin are outliers to the general rule … Michigan is particularly interesting since it has been one of the most locked down, masked states … yet, the state has a relatively low vax rate (which their wacky gov has laid off against supply constraints) … and still has a sky high death rate.
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Bottom line: Covid death rates are a lot more complicated than simply tying them to vaccination rates.
Are the most vulnerable being vaccinated? What other factors are in play?
We’ll keep thinking about it … your thoughts?
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May 26, 2021
I’ve been digging into the surprisingly slow decline in the daily covid rates.
Let’s start with some state-by-state data…
Relevant time series data is hard to find, but I was able to find month ago cumulative covid deaths by state that I could match against current cumulative totals to calculate the number of deaths in the past month.
And, the answer is…
In total, there were just under 22,000 covid deaths in the US over the past month.
Data check: That’s about 750 deaths per day
10 states — which house about 1/2 of the US population — accounted for about 2/3’s of the total covid deaths in the past month.
Of course, the death count is a function of states’ population and their death rate (usually reported per million residents).
So, highly populated states states are heavily represented in the Top 10, e.g. Florida, California, Texas and New York.
But, it’s not just a matter of population.
The death rate in Top 10 states is running about 20% higher than the national average … and is about 50% higher than in the other 40 states (79.7 deaths per million versus 51.4).
A couple of the Top 10 states had death rates that were below the national average: California, Texas and Ohio.
So, their presence on the Top 10 list can be mostly attributable to population.
Conversely, a couple of Top 10 states are still on fire…
Leading the pack: Heavily locked-down Michigan — which tops the Top 10 list — had more than triple the national average of covid deaths over the past month (215 deaths per million versus to 67).
Pennsylvania and New Jersey each had more than 100 deaths per million in the past month.
Hmmm.
So, what explains the variance in death rates across states?
Spoiler alert: It’s not vaccination rates.
Stay tuned … more to come.
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May 18, 2021
What’s up with the covid cases and deaths data?
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To be crystal clear: I’m thrilled that the mask mandate has been ditched … and, I’m supremely confident that it’s not coming back.
But, I’m puzzled by “the data” that “the science” followed to make last weeks surprise mask announcement.
So, let’s drill down …
Below is our standard chart of cases & deaths — indexed to November 1st ( just to keep the series plotted on a common chart).
Unpacking the numbers, covid-related deaths peaked at about 2,000 per day in January … and have ranged around 650 for the past 6 weeks or so.
For reference, a high flu season averages about 500 deaths per day during the roughly 4 month flu season.
My take: We shouldn’t declare victory against covid until the death rate drops below 500, for sure or, more conservatively, below 250.
I’ve longed argued that the daily death count is the purest metric of covid severity.
That said, let’s look at the case numbers that Biden , Fauci and Wolensky like to point to.
Note that cases peaked at about 200,000 per day right around Biden’s inauguration.
Then, case counts dropped quickly and sharply, almost miraculously, to under 100,000 … hovering around 65,000 for the past couple of months.
That is, until about a month ago … when case counts turned down again … to its current level of about 35,000 … which Biden says justified “relaxed guidance”.
Source: Bloomberg
So why have case counts dropped so much since Inauguration Day?
It could be that Biden is a miracle worker … or, it could be that the vaccines are kicking in … or, it could be another reason.
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Below is the JHU chart that tracks the number of daily covid tests.
Note how closely the number of tests and the number of confirmed cases seem to track.
In the month after Biden’s inauguration, testing dropped by 25% from about 2 million per day to under 1.5 million per day … and hovered there for a couple of months.
But, in the past month, testing has fallen to just over 1 million per day …. a 33% drop.
Source: JHU
Let’s recap …
> Testing peaked around inauguration day … and so did cases. Coincidence?
> After a couple of months of level testing and cases, both data series turned down again in the past couple of weeks. Another coincidence?
Maybe I’m missing something….
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May 13, 2021
Early on in the pandemic, it was noticeable that:
(1) covid was spreading among locked down families — especially high density, multi-generational households and
(2) workers in some open businesses — think: grocery stores — weren’t experiencing pandemic levels of covid consequences.
Said differently, people confined to ostensibly protective “bubbles” were getting infected … but customer-facing workers weren’t.
Is this just Fauci-shunned non-projectible anecdotal evidence … or a relatively broad based truth?
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Casey Mulligan — a University of Chicago economist — studied that question and recently published his results in a research paper:
The Backward Art of Slowing the Spread? Congregation Efficiencies during COVID-19
Conventional public health wisdom held that lives would be saved by shutting workplaces and schools and telling people to stay home.
But, Mulligan found the opposite to be true:
Micro evidence contradicts the public-health ideal in which households would be places of solitary confinement and zero transmission.
Instead, the evidence suggests that “households show the highest transmission rates” and that “households are high-risk settings for the transmission of [COVID-19].
How can this be?
Mulligan argues that after the first months of the pandemic, organizations that adopted prevention protocols became safer places than the wider community.
Schools, businesses, and other organizations implemented a range of prevention protocols – from adjusting airflow to installing physical barriers to monitoring compliance to administering their own testing services – that households did not, and perhaps could not
But, households were bubble-fortresses isolated from the virus, right?
Wrong.
Few households were strictly “bubbled off” completely. The bubbles were routinely breached.
One or more members of practically all households would venture out to work or run errands — being exposed to the virus.
If the outside venturers happened to catch the virus, the other household members would be close-contact sitting ducks.
Without the business-level precautions, penetrated homes became veritable petri dishes for the virus.
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Mulligan’s conclusion:
Officials forgot that organizations are rational and look for cooperative solutions that improve the welfare of the group, such as reducing the risks of communicable disease.
Gee, who would have thought that self-interested private enterprises would be more creative, more efficient, more practical and more successful than government bureaucrats’ ivory-tower edicts..
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May 5, 2021
Is he a slacker? Or, a math-denier? Or, does he know something that we don’t know?
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Yesterday, Pres. Biden chest-pounded a new vaccination goal:
So, how ambitious is the new goal?
Here’s the back of the envelop:
There are about 250 million Americans over 18
70% of 250 million is 175 million
According to the once reliable CDC, about 145 million adults (over 18) have already gotten 1st shots
That makes the “go get” number 30 million 1st shots
We’re currently averaging just under 1 million shots per day.
So, it should take about 30 days to close the gap.
That puts us in early June… not July 4
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So, what the heck is going through Biden’s mind?
> Is he intentionally setting a low bar (like the 100 million doses in his first 100 days) to ensure another end zone celebration?
> Did he just mouth the teleprompter wrong again (ala “no one earning less than $400,000 will pay a penny of taxes”)?
> Or, has he officially jumped on the new-new math that doesn’t have right answers?
> Or, does he know something that his advisors won’t let him tell us?
Hmmm.
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P.S. I’ve adjusted the official HomaFiles’ daily dashboard calculations to reflect Biden’s new goal.
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May 4, 2021
Back in early February, Dr. Scott Gottlieb — a former FDA Commissioner — offered a projection that stuck in my mind.
In a WSJ op-ed, Gottlieb wrote:
After early challenges, vaccine delivery is keeping up with supply.
But by the end of March, the monthly vaccine supply may reach 100 million doses.
With improved delivery, at some point, perhaps in April, supply will start exceeding demand.
Sure enough …
For example, at a micro level…
Back in February when I was in the heat of my vax hunt, CVS “offered” covid vaccinations at about a dozen stores in Maryland.
I say “offered” because “availability” was scarce and scoring an appointment had about the same odds as winning lotto.
See VAX: I got mine … and it wasn’t easy!
Today, CVS offers shots at more than 100 locations … and the vast majority of them have vaccine available on any given day.
Aggregating up to the macro level, the CDC reports that the stockpile of doses “distributed” but not yet “administered” is over 70 million doses … and growing.
About 40 million doses are, in effect, being held in reserve for second shots.
Given the large, free flow of supply from Pfizer and Moderna, It’s not evident why these 40 million need to be sequestered for future use.
And, even if there is a just reason, it still leaves a stockpile of over 30 million doses … compelling evidence that supply is now exceeding demand … by a lot!
Which validates Gottlieb’s February warning:
The challenge won’t be how to ration a scarce resource, but how to reach patients reluctant to get vaccinated.
Yep, that’s where we are … and, it should have been anticipated.
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April 13, 2021
Stay focused on the number of Daily New Deaths!
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Now that the country is getting vaccinated at a rapid clip, everybody is asking the same question: When can we resume “normal” life again?
The verbiage from the political-scientists and pundits ranges from ‘pretty soon’ to ‘probably never’.
Thanks guys.
Is herd immunity within reach or asymptotically impossible because of ”vaccine hesitancy”?
How many covid survivors now have “natural immunity”?
How long does natural or vaccine immunity last? Weeks? Month? Years?
Case counts spike then drop like a rock … with “scientific” explanations mimicking financial analysts’ head-scratching rationales for why the market went up (or down) each day.
My advice from the get-go has been — in the words of Nate Silver — to ignore the noise and focus on the signal … the covid-related death count.
Back in Jan.-Feb. 2020, Dr. Fauci was saying:
This not a major threat for the people of the United States, and this is not something that the citizens of the United States right now should be worried about.
I bought in to Fauci’s read of the situation, but said that I’d start worrying when daily covid deaths surpassed those of a a bad flu year.
The were about 80,000 flu-related fatalities in worst recent flu year. Source
Spread across the entire year, that works out to about 250 deaths per day; spread across the usual 4 month flu season, that’s about 750 deaths per day.
Of course, we blew past those numbers … and stayed at sky-high levels for most of the past year.
Now, we’re coming back down … with enough people vaccinated or naturally immune that the trend and levels are likely to stick.
So, my advice: Take case counts with a grain of salt, be encouraged by vaccination rates and stay focused on the averaged number of daily new deaths (DNDs).
Based on the flu benchmark, when the weekly average of DNDs drops below 750, we’re probably near-normal … when it drops below 250, then giddyup … we’re there!
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For more detail. see: MUST READ: How will we know when we’ve turned a COVID-19 corner?
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April 13, 2021
Stay focused on the number of Daily New Deaths!
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This is a relevant excerpt from a long ago prior post (May 2020)
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Why have I centered on Daily New Deaths (DND) as my key metric?
First, saving lives is our paramount objective, right? If yes, it should be our focus metric.
Second, I think that most other metrics that are being bandied about are quite problematic.
Counting deaths — while a bit macabre — is a more reliable process than counting, say, the number of infected people.
Sure, I’d like to know the number of people infected with COVID-19.
But, unless everybody — or at lest a large statistical sample — is tested, the number of confirmed cases is subject to lots of statistical issues.
Most notably, who is being tested and who isn’t? What about the asymptomatic “hidden carriers”? What are the criteria for confirming a COVID infection? What about false positives (and false negatives)? How to standardize the reporting processes across states? How to keep governmental units from fudging the numbers?
Importantly, if testing increases, then confirmed cases goes up.
Is that an indication of more virus spread or just a reflection of more testing?
I sure can’t tell.
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Again, counting fatalities is probably the most reliable metric.
Fatalities are discrete events – so they’re countable.
Still, even deaths may have some counting imperfections.
For example, many non-hospitalized people die and are buried without autopsies. Some may be uncounted COVID victims.
On the other hand, some people may die and be diagnosed with COVID infections. That doesn’t necessarily mean that COVID killed them. That’s especially true with COVID since it’s most deadly for people with other health problems.
And, as we stated above, the definition of COVID deaths has changed:
COVID-related” means “COVID present”, not necessarily “COVID caused” … and that, along the way, “present” was redefined from “confirmed” to “presumed”
Further, COVID deaths are a function of two drivers: the incidence of the virus … and, the nature, level and timing of therapeutic healthcare.
Said differently, more effective therapeutic healthcare will dampen the death toll.
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Bottom line: “Daily New Deaths” is the number we should be watching.
If it shows a consistent downward trend, then we’ll know we’ve turned the corner.
If it stays stable (at a high level) or turns upward, we’ll know that we’re in deep yogurt.
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Posted in Coronavirus - Covid 19, Covid-19 Testing, COVID-19 Tracking, Uncategorized | Leave a Comment »
