Why is Maryland "Trending Poorly" on covidexit?

[Anonymous]

In terms of total number of cases - impacting overall state level, Baltimore County and City, have been increasing significantly over the past weeks. In the last 7 days, Baltimore county averaged 181 cases per day and Baltimore City, 155 cases a day. The concerning part is that poverty / risk demographics are worse in Baltimore City leading to likely higher risk and possibly quicker spread The Baltimore city hospitalizations and ICU numbers seem to be driving some of the state hospitalization increases. https://coronavirus.baltimorecity.gov/

[Anonymous]

Anonymous wrote:https://www.wbal.com/article/index/471709?title=Gov-Hogan-Announces-Expanded-Statewide-Mask-Order-Issues-Out-of-State-Travel-Advisory

The state is strongly advising against out-of-state travel to states where the positivity rate is above 10%, which, as of Wednesday, includes Alabama, Arizona, Florida, Georgia, Idaho, Louisiana, Nebraska, South Carolina and Texas.

"I directed the Maryland Department of Health to issue a public health advisory for all out-of-state travel. We are strongly advising against any travel to or from states with positivity rates of 10% or higher," Hogan said. "We are very concerned. We can't stop people from crossing the borders. Things are pretty much out of control in some of these states."

This public health advisory applies to personal, family or business travel. Anyone traveling to or from these states should get tested and self-quarantine.

Starting at 5 p.m. Friday, Maryland is expanding the statewide mask order, requiring face masks in public spaces of all businesses and in outdoor public areas whenever it is not possible to maintain physical distancing, Hogan said.

"Wearing a mask is the single-best mitigation strategy that we have to fight the virus, and the science and the data are very clear: It's the best way to keep you and your family safe, to keep people out of the hospital and to keep Maryland open for business," Hogan said.

Hogan still seems focused only on the positivity rate, probably because Maryland's seems low. Not one is talking about the rate of new cases per day per 100,000 -- which is why MD got dinged from so many North Eastern states.

MD's rate of new cases per day is really high, and our (at the moment) low-ish positivity rate is going to rise to reflect that very soon.

The positivity rate is down because lots of non symptom/low risk people are getting tested for travel and college. That was not happening a month ago.

[Anonymous]

Anonymous wrote:

Anonymous wrote:https://www.wbal.com/article/index/471709?title=Gov-Hogan-Announces-Expanded-Statewide-Mask-Order-Issues-Out-of-State-Travel-Advisory

The state is strongly advising against out-of-state travel to states where the positivity rate is above 10%, which, as of Wednesday, includes Alabama, Arizona, Florida, Georgia, Idaho, Louisiana, Nebraska, South Carolina and Texas.

"I directed the Maryland Department of Health to issue a public health advisory for all out-of-state travel. We are strongly advising against any travel to or from states with positivity rates of 10% or higher," Hogan said. "We are very concerned. We can't stop people from crossing the borders. Things are pretty much out of control in some of these states."

This public health advisory applies to personal, family or business travel. Anyone traveling to or from these states should get tested and self-quarantine.

Starting at 5 p.m. Friday, Maryland is expanding the statewide mask order, requiring face masks in public spaces of all businesses and in outdoor public areas whenever it is not possible to maintain physical distancing, Hogan said.

"Wearing a mask is the single-best mitigation strategy that we have to fight the virus, and the science and the data are very clear: It's the best way to keep you and your family safe, to keep people out of the hospital and to keep Maryland open for business," Hogan said.

Hogan still seems focused only on the positivity rate, probably because Maryland's seems low. Not one is talking about the rate of new cases per day per 100,000 -- which is why MD got dinged from so many North Eastern states.

MD's rate of new cases per day is really high, and our (at the moment) low-ish positivity rate is going to rise to reflect that very soon.

The positivity rate is down because lots of non symptom/low risk people are getting tested for travel and college. That was not happening a month ago.

Right. Cases per 100,000 is one metric but that's why you have to look at ALL of these with this virus, because of the high-ish number of very mild cases (and I mean truly mild, not just "not hopsitalized".) Because even if you have a very high number of people per 100,000 testing positive, if a significant number of those are asymptomatic or truly mild, you do not need to shut down your economy again.

[Anonymous]

Anonymous wrote:

COVID Exit Strategy has added a new heading: Is Contact Tracing Possible (at your level of spread). FOR MD they say it is unlikely.

Also positivity seems to keep going up? I know that the official rate on the MD state website is lower for some reason than here on covidexitstrategy, but going up is a problem nonetheless.

[Anonymous]

Anonymous wrote:
Right. Cases per 100,000 is one metric but that's why you have to look at ALL of these with this virus, because of the high-ish number of very mild cases (and I mean truly mild, not just "not hopsitalized".) Because even if you have a very high number of people per 100,000 testing positive, if a significant number of those are asymptomatic or truly mild, you do not need to shut down your economy again.

It's looking like the places (countries, states) that are doing best with COVID are those that are getting their numbers down to two things:

- New cases per 100,000 per day of 1 or fewer
- percent positive of tests at 2% or lower
- testing a large number of people each day

All three things work together to validate that there are few cases going around and that things can get back to normal and you can "reopen your economy".

If we try to "reopen the economy" too early (before those low levels have been reached) we won't be able to use contact tracing when we have outbreaks, and this is going to drag on and on and on and on and on.

Getting down to 5% positivity and 4 new cases per 100,000 per day apparently isn't good enough, which is why MD is having trouble now.

[Anonymous]

And anyhow, MD isn't close to 4 new cases per 100,000 per day ... more like 14.

I WANT MARYLAND TO BE A GREEN STATE. I want to be able to travel with no quarantine to NY and NJ and Maine.

[Anonymous]

Anonymous wrote:And anyhow, MD isn't close to 4 new cases per 100,000 per day ... more like 14.

I WANT MARYLAND TO BE A GREEN STATE. I want to be able to travel with no quarantine to NY and NJ and Maine.

Its probably not going to happen until it burns through like nj and ny who probably have some levels of herd immunity

[Anonymous]

Anonymous wrote:

Anonymous wrote:And anyhow, MD isn't close to 4 new cases per 100,000 per day ... more like 14.

I WANT MARYLAND TO BE A GREEN STATE. I want to be able to travel with no quarantine to NY and NJ and Maine.

Its probably not going to happen until it burns through like nj and ny who probably have some levels of herd immunity

One question I have is why do the deaths per day continue to be so much higher in NJ and NY if they are doing so well

For instance on 7 day ave - NY is 17, NJ is 20, mass is 16

In comparison, VA is 10 and MD is 10.

Even adjusting populations / lags that doesn’t make sense if those states have been doing well now for month(s)

[Anonymous]

Anonymous wrote:

Anonymous wrote:And anyhow, MD isn't close to 4 new cases per 100,000 per day ... more like 14.

I WANT MARYLAND TO BE A GREEN STATE. I want to be able to travel with no quarantine to NY and NJ and Maine.

Its probably not going to happen until it burns through like nj and ny who probably have some levels of herd immunity

Burn through poster -- your hypothesis doesn't make sense. Many parts of upstate NY did not have a large number of people infected with COVID. COVID didn't burn through the population, yet they still have very low rates of spread now.

[Anonymous]

Anonymous wrote:

One question I have is why do the deaths per day continue to be so much higher in NJ and NY if they are doing so well

For instance on 7 day ave - NY is 17, NJ is 20, mass is 16

In comparison, VA is 10 and MD is 10.

Even adjusting populations / lags that doesn’t make sense if those states have been doing well now for month(s)

I don't know about deaths, because yes those can lag weeks or even a month or more.

A better measure is rate of hospitalization, per million people.

New York: 32 hospitalized per million (downward trend)



New Jersey: 86 hospitalized per million (downward trend)





Maryland: 94 hospitalized per million (upward trend)



For comparison:

Florida: 406 hospitalized per million (downward trend)



Maine: 8 hospitalized per million (downward trend)





Maine consistently has great metrics. New Jersey is looking a little bit bad in comparison with NY and they might be headed to a color change from green to yellow.

[Anonymous]

Ooof.

MD hit the 150 new cases per million per day mark:

[Anonymous]

Anonymous wrote:

Anonymous wrote:
Right. Cases per 100,000 is one metric but that's why you have to look at ALL of these with this virus, because of the high-ish number of very mild cases (and I mean truly mild, not just "not hopsitalized".) Because even if you have a very high number of people per 100,000 testing positive, if a significant number of those are asymptomatic or truly mild, you do not need to shut down your economy again.

It's looking like the places (countries, states) that are doing best with COVID are those that are getting their numbers down to two things:

- New cases per 100,000 per day of 1 or fewer
- percent positive of tests at 2% or lower
- testing a large number of people each day

All three things work together to validate that there are few cases going around and that things can get back to normal and you can "reopen your economy".

If we try to "reopen the economy" too early (before those low levels have been reached) we won't be able to use contact tracing when we have outbreaks, and this is going to drag on and on and on and on and on.

Getting down to 5% positivity and 4 new cases per 100,000 per day apparently isn't good enough, which is why MD is having trouble now.

What is Maryland having trouble with exactly? Because as far as I can tell, hospitalizations are still low and manageable...

[Anonymous]

Anonymous wrote:
What is Maryland having trouble with exactly? Because as far as I can tell, hospitalizations are still low and manageable...

It turns out that keeping hospitalizations low isn't the best way to deal with COVID.

Because this virus spreads exponentially, the best way to keep it from spreading (and getting to a level that will make hospitalizations really bad) is to intervene very early, and keep new cases per 100,000 per day under 1.

MD is now at 15 new cases per 100,000 per day, and at that level contact tracing becomes almost impossible, and we are running short on testing capacity as well. It's like letting a candle flame become a small fire. True, it isn't burning our house down yet but it is much better to just blow out the candle flame, rather than have to stamp out a small fire.

[Anonymous]

This is what we need to be doing:

https://globalepidemics.org/wp-content/uploads/2020/06/key_metrics_and_indicators_v4.pdf

Mitigation = some reduction in the rate of R (the reproduction number of the virus) through diagnostic testing and contact tracing.
Suppression = an effort to get to zero or near zero case incidence.

Both mitigation and suppression require a suite of activities ranging from stay-at-home advisories to 6-foot social distancing to mask wearing to TTSI implementation. TTSI is a tool that can be deployed at either mitigation or suppression levels. However, we strongly recommend jurisdictions that have the capacity to deliver suppression-level surge resources for TTSI to pursue a suppression strategy as they will be on the most efficient path toward a restored economy without future lockdowns

Maryland is already midway into the orange level, and since we aren't doing much suppression it will be a matter of weeks before we are at the red level.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
Right. Cases per 100,000 is one metric but that's why you have to look at ALL of these with this virus, because of the high-ish number of very mild cases (and I mean truly mild, not just "not hopsitalized".) Because even if you have a very high number of people per 100,000 testing positive, if a significant number of those are asymptomatic or truly mild, you do not need to shut down your economy again.

It's looking like the places (countries, states) that are doing best with COVID are those that are getting their numbers down to two things:

- New cases per 100,000 per day of 1 or fewer
- percent positive of tests at 2% or lower
- testing a large number of people each day

All three things work together to validate that there are few cases going around and that things can get back to normal and you can "reopen your economy".

If we try to "reopen the economy" too early (before those low levels have been reached) we won't be able to use contact tracing when we have outbreaks, and this is going to drag on and on and on and on and on.

Getting down to 5% positivity and 4 new cases per 100,000 per day apparently isn't good enough, which is why MD is having trouble now.

What is Maryland having trouble with exactly? Because as far as I can tell, hospitalizations are still low and manageable...

Hospitalizations and deaths are lagging from number of cases. So when you start to see an increase in the number of cases (mid July) 2 - 4 weeks later (ie, just about now or the next week or so) you'll see increase in hospiatlizations, and two weeks or so after that, increase in deaths.
It's so dangerous to ignore increasing cases and increasing positivity rate just beacuse hospitalizations haven't (yet) started increasing.