Something Surprised Me In The COVID Numbers

[ProfessorGAC]

We're breaking records in cases for on a day basis & the 7 day average. We're nearly 2x that of the prior surge in mid-June to mid-August.
But, the daily deaths are about the same, & they're only about half of what they were in April, when we were consistently above 2k deaths per day, but only 35-40,000 cases per day.
Is it because slight improvements in treatment that saves a higher fraction?
Is it because so many of the most vulnerable have succumbed?
Could the virus have mutated to a form more contagious, but a bit less pernicious?
Some combination of those?
Just wondering what others think as to why cases are stupendously high but deaths, as bad as they are, aren't close to record level?
I'm linking to the Worldometer graphs, if you'd like to take a look for yourself.

https://www.worldometers.info/coronavirus/country/us/

[apcalc]

1. Younger people getting infected, less likely to die.

[SheltieLover]

6. Very true!

I'd overlooked that factor. Ty!

[Phoenix61]

2. Deaths lag by at least 2 weeks.

It can take 2-8 weeks before someone dies from covid. It also takes time for deaths to be recorded.

[ProfessorGAC]

15. Did You Look At The Graphs?

The don't demonstrate a 2-8 week lag as you suggest.
The peak & plateau are much closer time correlated than a lag like that.

[SheltieLover]

3. Just a guess

But I'm going with covid deaths being attributed to other causes.

[uponit7771]

4. Deaths track closer to hospitalizations than cases, the deaths come 2 - 3 weeks after peak ....

... hospitalizations depending on the speed of the rise in hospitalizations.

We're not close to the hurt ... this hurt will be bigger than the others.

[Skraxx]

5. It's Mostly Treatment From What I've Seen

We're much better at it and have better methods now and we're more prepared. I've seen some of the research and data and this is also what I'm hearing from colleagues.

BTW, good to see you old friend, you knew me by another name in the old days...Beetwasher...

[ProfessorGAC]

17. Beet!

Yeah, I'm still here! Retired now, nearly 2 years.
I'm now a former scientist!
You doing ok?

[Skraxx]

32. Good to See You!

All's well. Working at a local medical center/research institute/social services org, a one-stop shop as it were, specializing in ID actually, with some good partnerships at Rutgers, NYU and various Pharmas, etc.

Congrats on your retirement my friend! You've more than earned it. And your "hobby" of enriching us all with your wisdom is greatly appreciated.

[drray23]

7. Medical experts have made it clear that we are better

at treating the symptoms and keeping people alive. The bulk of death also lags infection spikes by a few weeks.

[BusyBeingBest]

8. Some combination of all of those.

I think the medical community has a better understanding of what they're dealing with now, most of all--clotting issues, ventilator use and settings, steroids, remdesivir, etc.

[bullimiami]

9. I think, yes, more young people and improvements in care but deaths can lag by 4-6 weeks

Well have to see where the deaths peak compared to the case peak.

I think we’re still between 2.5 and 4% mortality.

[former9thward]

19. No evidence for those figures.

Both the CDC and WHO say probably 10 times the known infections are the actual number due to asymptomatic cases. That would mean a true mortality rate of 0.4% or so. We do not test random people in the population. We only test those with symptoms.

[bullimiami]

23. true. without widespread testing we dont know how many asymptomatic cases there are but ...

we can extrapolate from the known cases and known deaths and i'll use the most generous math ..

US currently has ~250,000 deaths and 11,500,000 verified cases.

This gives you a little over 2% of verified cases resulting in death.

So if we have a 150,000 cases in a day it likely will result in 3000 deaths eventually.
And if were averaging 150,000 cases a day for some time.
That at some time in the future we will likely have a sustained peak of something like 3000 deaths per day.

I could make an argument that only resolved cases and deaths truly make up the mortality rate, that would be much worse.

Yes, we dont know what we dont know.

[Blues Heron]

10. more availibility of testing picking up milder cases?

I was wondering the same thing.

[Mariana]

13. It was very difficult to get a test in the spring in most places.

My husband and I had something that was probably not Covid-19 in late March. We had a cough that went on for weeks, but we had no fever, so we couldn't get tested. My cousin actually did have Covid-19 at the same time, and he was sick for more than a week before he could get permission to have a test. I'm sure lots of mild cases didn't get counted.

[IsItJustMe]

34. It's so easy where I live now to get a test and I think a lot more people are taking advantage

of it than they were were earlier in the year.

That means, to me, that you are getting a truer barometer of those people who catches it and those people who die from it.

[Mariana]

11. It ran wild in nursing homes and such places in the spring

before anyone really knew it was spreading in the US. That alone accounts for much of the difference, since those residents are being much better protected now.

[Midnight Writer]

29. Yep, that's what happened here. We had a shock early on when it hit nursing homes.

I think a lot of nursing facilities have hardened their defenses.

Also, I believe widespread testing is giving a better picture of the number of infections.

Plus, more knowledgeable treatments. They were at a loss for knowing what to do early on. As they gained experience with the illness, they were able to make better and more effective treatment decisions.

[IsItJustMe]

36. Yeah. They figured out that putting people on ventilators was a really bad thing.

Now, it's a last resort. Being on a ventilator, in and of itself, is an extreme measure.

[Mariana]

41. Another factor in the very high death rate among nursing home residents

in addition to them being old and frail, is that many of them have Do Not Resuscitate orders, and/or Living Wills that prohibit them from being put on life support devices like ventilators.

[Celerity]

39. That is what blew us up here in Sweden at the very beginning (our elderly care homes and scattered

site care homes were just crushed.

Amongst the lower half (age wise) of the population (around 5.05 million people) we have, YTD, had only 31 total COVID-19 deaths, zero of them schoolchildren. Under the age of 20 we have had 2 deaths, a 4 year old who died 6, 7 months ago, and an infant, both with multiple comorbidities).

In US terms, that would be like the bottom (age wise) 165.5 million people having around 1,016 total deaths, YTD.

here are the CDC umbers sorted by US age group

they are lagging, but this you a fair amount of data

https://data.cdc.gov/NCHS/Provisional-COVID-19-Death-Counts-by-Sex-Age-and-S/9bhg-hcku

[ramblin_dave]

12. More people are wearing masks now compared to April

Masks reduce the viral load (on average) to a more manageable level.

[ProfessorGAC]

14. Thanks!

Thought of that earlier today, but forgot to add that.
Glad you chimed in.

[lapfog_1]

16. This...

[AlexSFCA]

18. back in April, VERY few people got tested

the spread was much larger than confirmed cases indicate

[ProfessorGAC]

21. Certainly Possible

But, deaths were 2x. That would suggest cases were 6x what they were.
That would mean things were worse then than they are now.
Might be.

[MaryMagdaline]

20. Treatment is getting better - my GP just told me this today

[lapfog_1]

22. Let me summarize the thread here

1. We are doing more testing. In the earlier "wave" we likely had 10x the number of actual infections than tested positive infections ( people who never got tested, didn't go to the hospital )... that ratio is now like maybe only 2x or possibly 3x.

2. We have learned how to treat this disease and save more lives... In particular I would call out Dexamethasone to suppress our immune response to the virus given at the right time and in the right dose. Suppress the immune response... YES... we were dying because our own immune response was killing us.

3. Younger people are now being infected because they a) went back to school and b) think that this is still a "boomer remover" and they won't get sick (sadly, quite a few found otherwise but they are less likely to die).

4. We are wearing masks... masks may not entirely protect you from getting the virus but studies are showing they reduce the viral load. That lower load you were exposed to allows your body to mount a slower (and therefore safer) immune response (see answer 2).

5. Some of us (quite a few) are taking Vitamin D (Dr. Fauci, for example, is taking 6000 IUs a day). Vitamin D has been shown to be effective in supporting your immune system in fighting this disease. Some are also taking Zinc... but there is less evidence that this is effective.

6. Some of the sicker people are getting Remdisivir, which has been shown to reduce the time a very sick person is in the hospital... meaning that they are less likely to pick up an opportunistic germ or other virus (like pneumonia).

7. And this is is merely speculative on my part... there are at least two mutations of SARS-Cov-2 in the US. One ( lets call it the Italian variant ) is more deadly than the other one ( the Wuhan variant ). NYC in March was getting the Italian mutation... most of the West Coast has had the Wuhan variant ( less deadly ). I have NO evidence of this... to have that evidence you would need to completely sequence the RNA... and we just don't do that.

end result... less death compared to positive tests... and even less death than hospitalizations.

However, as we hit new highs in infection and our hospitals become overwhelmed... our death rate will increase, possibly dramatically, because we simply can't treat all the sick people with the level of care currently employed with people getting severely ill.

[Pobeka]

26. Excellent summarization. Thank you for that. n/t

[Buckeye_Democrat]

28. Excellent post!

[Dem2]

35. Thanks

I saw bits and pieces, but wanted to comment. Then I saw your summary and now I don't need to.

[IsItJustMe]

37. Ding. Ding. Ding.

I think you got it.

[Demsrule86]

24. There is a lag in deaths ...first cases increase and then deaths increase.

[pat_k]

25. Some combination -- mainly more testing of asymptomatic

I have been tracking the same thing and have been happy to see it.

I've generally only paid attention to hospitalizations (here) and daily deaths (here). Hospitalizations and deaths are not affected by what percentage of the population is getting tested.

There is a reason the following note is at the top of the "Daily Deaths" chart on the IMHE covid tracking site

Daily deaths is the best indicator of the progression of the pandemic, although there is generally a 17-21 day lag between infection and deaths.

I think improvements in care are reflected in lower deaths relative to hospitalizations. (I pick a state with a "bumpy" curve, pick few hospitalization data points in time and then compare to deaths' a week or so after each.) It's not particularly scientific, but there does appear to be a reduction in death rate.)

So better treatment may be a factor. We may also be seeing mutation affecting the virus "kinetics" (they are on the look out for such changes, so if that's the case, we'll probably hear about findings).

I think the biggest factor is more widespread testing of asymptomatic and younger people detecting more cases.

For quite some time, testing was focused on those who were more vulnerable or who clearly showed symptoms. Now businesses are proactively testing and detecting cases that would previously have gone undetected. There are also new testing requirements that result in more asymptomatic people getting tested. (For example, the University of Washington dental clinic requires a confirmed negative test less than 48 hours before work is done.)

[LAS14]

27. Old people have learned to isolate and young people are no longer isolating.

Young people are way less likely to die. Not just my idea. Some talking head said that hospitilizations were down for that reason. Of course, if you're in a really bad outbreak, hospitilizations and deaths go up.

[lettucebe]

30. They've made great strides in how to treat; far better survival rate

That's what I've heard. Sorry no links or sources.

[mopinko]

31. they're lying.

there was a story here this a.m. about a family in florida that couldnt get a loved one's body tested by the state, so they did it themselves. yes, died of the rona.

they are lying not only about the body count, but the case count.

[IsItJustMe]

38. I think there is some truth to what you are saying.

If you dig into it, every state has its own way of counting who has Covid-19 and who has died of it. Last I saw, Texas would not count you as having Covid unless you took a particular test. The other test did not count.

Some states don't even count your death, unless you are a citizen of that state. Last time I checked, Florida tallied there death toll in that manner. Those people are most likely falling through the cracks and are not being counted at all.

Without a national standardized way of accumulating these numbers, you have to wonder if the numbers are actually reflecting the reality of what is going on.

[mopinko]

40. well, in ny, it was 1-10 that died.

even if treatment is twice as good now, that's 1-5.
and since the case counts are also a lle in red states....

imho, it's closer to 1m than 1/4m.

[IsItJustMe]

42. I have done lots of studying on this matter

with different countries. Sometimes it's like trying to compare apples and oranges because of the demographics that are particular to each country. If I had to make a ball park figure, I believe 1 out of 100 people are dying of this virus worldwide.

[JCMach1]

33. Treatment has advanced quite a lot

Having said that, deaths lag the case spike.

[MoonlitKnight]

43. Can we finally recognize reality?

Deaths lag cases as many stated. Now we can see...again.

[ProfessorGAC]

44. Hilarious!

You talking reality.
You clearly didn't look at the numbers, and you clearly didn't read the OP for comprehension.
I was talking about the lower death rate despite the explosion in cases. Guess you missed that.
Also, numbers show that yesterday's 7 day moving average was still below those of mid April. (By nearly 100).
But, daily case load is 6.25 higher than that same time.
But, if you wish to double down on wrong, be my guest.