Why is Maryland "Trending Poorly" on covidexit?

[Anonymous]

Anonymous wrote:

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.

Let's really think about this though. Hospitalizations previously peaked in Maryland at the end of April. 24-hour change in cases however previously peaked in May (until recently). Here we are in July, and we didn't see a massive jump in hospitalizations in mid to late June from the May spike. Why is that? I don't think anyone knows for sure, and there are lots of theories being tossed around, but the theory that an increase in cases leads to an absolute increase in hospitalizations isn't absolute.

(Before I get attacked, I'm truly here to just try to understand the numbers and the behavior, not trying to say let's just say f*ck it and stop trying to mitigate it. I'm just a analytical mind who finds this all so confusing and thus, fascinating.)

[Anonymous]

Cases in MD were pretty flat throught late June. They started rising in early July and have been rising more rapidly in late July.

We will see a rise in hospitalizations throughout the end of August, and the rise in deaths will start first week of September and continue to rise through early October.

[Anonymous]

It's interesting that MD's ICU beds have stayed pretty steady as hospitalizatons are increasing overall. The number of deaths have stayed steady too, since the 4th of July.

Younger cases? Better treatments?

[Anonymous]

Anonymous wrote:Cases in MD were pretty flat throught late June. They started rising in early July and have been rising more rapidly in late July.

We will see a rise in hospitalizations throughout the end of August, and the rise in deaths will start first week of September and continue to rise through early October.

Is this due to increased testing? What does the percent positive number look like?

[Anonymous]

Anonymous wrote:It's interesting that MD's ICU beds have stayed pretty steady as hospitalizatons are increasing overall. The number of deaths have stayed steady too, since the 4th of July.

Younger cases? Better treatments?

Hogan said in his press conference this week that it's younger patients who are sick, but not sick enough for ICU.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Cases in MD were pretty flat throught late June. They started rising in early July and have been rising more rapidly in late July.

We will see a rise in hospitalizations throughout the end of August, and the rise in deaths will start first week of September and continue to rise through early October.

Is this due to increased testing? What does the percent positive number look like?

That's been staying consistently around 4.5 to 4.6%.

[Anonymous]

Anonymous wrote:

Anonymous wrote:It's interesting that MD's ICU beds have stayed pretty steady as hospitalizatons are increasing overall. The number of deaths have stayed steady too, since the 4th of July.

Younger cases? Better treatments?

Hogan said in his press conference this week that it's younger patients who are sick, but not sick enough for ICU.

That and back in April/May, we don’t have a clear picture of how many people were actually infected because of inadequate testing, so we shouldn’t expect the same proportion of hospitalizations/deaths, because less severe cases are being documented now. During the initial surge, only the really sick were being tested, so of course a lot of them would require hospitalization.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Cases in MD were pretty flat throught late June. They started rising in early July and have been rising more rapidly in late July.

We will see a rise in hospitalizations throughout the end of August, and the rise in deaths will start first week of September and continue to rise through early October.

Is this due to increased testing? What does the percent positive number look like?

That's been staying consistently around 4.5 to 4.6%.

We need to keep testing until the positivity rate gets down to 2% consistently. Then we will be reasonably sure that we are catching most cases and have an accurate number.

[Anonymous]

Maryland is the next Mississippi.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:It's interesting that MD's ICU beds have stayed pretty steady as hospitalizatons are increasing overall. The number of deaths have stayed steady too, since the 4th of July.

Younger cases? Better treatments?

Hogan said in his press conference this week that it's younger patients who are sick, but not sick enough for ICU.

That and back in April/May, we don’t have a clear picture of how many people were actually infected because of inadequate testing, so we shouldn’t expect the same proportion of hospitalizations/deaths, because less severe cases are being documented now. During the initial surge, only the really sick were being tested, so of course a lot of them would require hospitalization.

Exactly. Back in April/May, let's say you had 1,000 cases/day and at the worst point, 1000 hospital beds filled. We're hitting similar numbers again (over 1000 cases) but not everyone needs the hospital because we're catching more mild cases. So again, just because we see an increase in cases, we may NOT see a surge in hospitalizations to the same degree. We're catching younger/healthier people, mild cases, etc, so we don't necessarily need to full on panic that hospitals are going to be overwhelmed in two weeks. We need to be cautious but that doesn't mean return to stay at home orders.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Cases in MD were pretty flat throught late June. They started rising in early July and have been rising more rapidly in late July.

We will see a rise in hospitalizations throughout the end of August, and the rise in deaths will start first week of September and continue to rise through early October.

Is this due to increased testing? What does the percent positive number look like?

That's been staying consistently around 4.5 to 4.6%.

We need to keep testing until the positivity rate gets down to 2% consistently. Then we will be reasonably sure that we are catching most cases and have an accurate number.

Note that Maryland calculates its positivity rate as the number of positive tests divided by total testing volume over a seven-day period. On the other hand, instead of the total testing volume, Hopkins uses the number of people tested, or the combination of new cases and people who tested negative. The Hopkins rate is usually higher than Maryland's, and has been above 6%, which is concerning.

https://coronavirus.jhu.edu/testing/testing-positivity

[Anonymous]

Correcting the link about for Maryland positivity rate:

https://coronavirus.jhu.edu/testing/individual-states/maryland

[Anonymous]

Anonymous wrote:
Note that Maryland calculates its positivity rate as the number of positive tests divided by total testing volume over a seven-day period. On the other hand, instead of the total testing volume, Hopkins uses the number of people tested, or the combination of new cases and people who tested negative.

Isn't the number of people tested the same thing as testing volume?

[Anonymous]

covidexitstrategy also repeatedly has MD's test positivity at at least 1% point higher than MD's own reporting, which has concerned me, especially because MD seems to be relying mostly on positivity to determine if we are in trouble (they don't seem to be focused on new cases per 100,000 per day since "positivity is stable")

[Anonymous]

Anonymous wrote:

Anonymous wrote:
Note that Maryland calculates its positivity rate as the number of positive tests divided by total testing volume over a seven-day period. On the other hand, instead of the total testing volume, Hopkins uses the number of people tested, or the combination of new cases and people who tested negative.

Isn't the number of people tested the same thing as testing volume?

Some people are tested multiple times. If you look at the testing volume vs. number of new confirmed cases you actually see the percentage figure isn't correct. Not sure how they calculate it but it is off.