Coronavirus

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Wayland
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In reply to Ground_Chuck • 8:07a, 4/13/20
Ground_Chuck said:
Wayland said:
Mormad said:
Fauci isn't in the minority when he says he thinks there will be a second wave in November. Everything I receive from different medical sources every day predicts the same thing.


And a month ago 2.2 million Americans were going to die, and the state of NC released an analysis partly based on the report this week.

There may be a second wave, but what does it look like. Is NY pushing HI at this point, their infection rate must be insane. Or at least a critical mass infection rate.

Maybe on the next wave we will actually protect nursing homes unlike this time.


You didn't accurately process the information regarding the 2.2 million number. That number was the best estimate of what would happen if we did nothing. That estimate was made 3 months ago, not 1 month ago.

The updated estimate from a month ago was 100,000 based on measures already taken and more localized R0 estimations.
https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf

March 16, 2020 is when the Imperial College report was released. "... in an unmitigated epidemic, we would predict approximately 510,000 deaths in GB and 2.2 million in the US, not accounting for the potential negative effects of health systems being overwhelmed on mortality. "

If you have a cited source that predates that, I would love to see it, and will review it.

The first IHME models (where everyone is getting the 100k deaths -> 80k deaths -> 60k deaths) didn't come out until the last few days of March (about March 26) about 2 weeks ago. No one really paid attention until the March 30 model. And has been HEAVILY adjust since its early releases. I know since I remember when the first projections on IHME became public, I called them out that some of their resource data was incorrect.

http://www.healthdata.org/covid/updates

When we are all sitting at home we forgot how little time has actually passed. Weeks feel like months.
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packgrad
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In reply to Mormad • 8:23a, 4/13/20
Mormad said:
Thank you, Davie. Really excellent post.

I hope there is no logical and reasonable human being who truly believes that social distancing isn't affecting healthcare workers' lives or the silly immature completely uninformed statement that healthcare workers are more likely to burn out on making tik tok videos than the effects of the virus. Good Lord, man.


It was sarcasm. Good lord, man. Any objective onlooker can see the vast majority of hospitals are not being overrun with this virus. Talk of burnout from the virus causing 5-10% of medical professionals to leave is hyperbole on the level of Fauci.
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Mormad
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In reply to Wayland • 8:35a, 4/13/20
The key word is "unmitigated." Great link. Thanks for sharing it. The numbers aren't perfect for obvious reasons, but their models predicting the various effects of mitigating NPIs seem to be proving true. They also mention the plan for the future open back up do more than social distancing some of you guys wanna hear more of. Can't wait to read it more closely tonight.
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Mormad
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In reply to packgrad • 8:38a, 4/13/20
Didn't catch any sarcasm in those statements, and those statements are completely separable from the 5-10% number whether you meant them to be or not.
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packgrad
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8:39a, 4/13/20
Facebook group #ReopenNC calling for a protest tomorrow.

https://m.facebook.com/groups/1071729406534210/
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Wayland
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8:41a, 4/13/20
They aren't perfect, but we also had a lot less information on the virus then. A lot of the assumptions of the model are based on numbers out of Wuhan which we know to be nowhere near accurate.

And while he does provide a wide range of outcomes, which I appreciate, the only number that was latched onto by media was "2.2 million". It was a best guess, and I don't doubt the best intentions, due to the false virus data out of Wuhan it makes the conclusions wildly incorrect.

A month later we have a TON of higher quality data to do more predictive modelling. We shouldn't be relying strictly on months old Wuhan information. Is my point.

Not that the report doesn't bring up good discussion points that can be part of the larger conversation, but anytime any of these reports or studies come out, the only thing people latch on to is the highest number. Discussion is not allowed.
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packgrad
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In reply to Mormad • 8:43a, 4/13/20
No they're not. They were in response to the poster drunk trolling last night.
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cowboypack02
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In reply to packgrad • 8:55a, 4/13/20
packgrad said:
Facebook group #ReopenNC calling for a protest tomorrow.

https://m.facebook.com/groups/1071729406534210/
Good for them.
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acslater1344
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In reply to packgrad • 9:14a, 4/13/20
packgrad said:
No they're not. They were in response to the poster drunk trolling last night.

no reason to be a dick to healthcare workers. I agree with you more and more and this thread goes on, but no reason to be an ******* just because some drunk guy didn't agree with you.
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statefan91
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9:42a, 4/13/20
NPR's UpFirst this morning with a lot of talk about contact tracing and the need to have it in place for things to open up. That's why I've been so down on Cooper throughout this, there's no talk about the strategy to reopen, just a lot of talk about the stay at home order.
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Mormad
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In reply to Wayland • 9:58a, 4/13/20
I like the insight you offer even when I don't necessarily agree. I do agree about the latching on of numbers, but I have a different 10000 foot view of it for reasons I wont go into. I don't pay much attention to the media reports honestly. I get so much from the hospital and AMA and other sources via email each day so I just extricate myself from the things you are complaining about. Point is, I understand your complaints and do my best to appreciate them. I will say that the very link you provided offers insight and did its best to predict the effects of NPIs based on available data at the time and mentioned specifically how to re-open, when to re-open and the effects of re-opening things, and even when to re-close. More is being done with plugging ever changing (luckily smaller) numbers into similar models every single day by scientists behind the scenes than we know. We can only hope our government pays attention.
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Wayland
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In reply to Mormad • 10:11a, 4/13/20
Mormad said:
I like the insight you offer even when I don't necessarily agree. I do agree about the latching on of numbers, but I have a different 10000 foot view of it for reasons I wont go into. I don't pay much attention to the media reports honestly. I get so much from the hospital and AMA and other sources via email each day so I just extricate myself from the things you are complaining about. Point is, I understand your complaints and do my best to appreciate them. I will say that the very link you provided offers insight and did its best to predict the effects of NPIs based on available data at the time and mentioned specifically how to re-open, when to re-open and the effects of re-opening things, and even when to re-close. More is being done with plugging ever changing (luckily smaller) numbers into similar models every single day by scientists behind the scenes than we know. We can only hope our government pays attention.
Thanks, The media is either ill equipped or unconcerned with actually doing much research these days. And I appreciate the reasoned discussion and value your insight. When the numbers out of Guilford County mirrored your anecdotal evidence, I realized you were not just pulling numbers out of thin air.

We all have different sources and contacts and experiences which makes us view this through different lenses. We all want the best outcome. Reasoned disagreement is good to prevent groupthink and challenge perceptions.
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Mormad
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In reply to Wayland • 10:18a, 4/13/20
Absolutely agree
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RunsWithWolves26
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11:07a, 4/13/20
So Dr. Fauci says we could probably start opening some things back up in May. Is he ok to stay now or should he still be run off? Asking for a friend. TIA.
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packgrad
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In reply to RunsWithWolves26 • 11:10a, 4/13/20
Nah. New voices. Don't need a cult leader in there. He's supposed to be an advisor.
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Wayland
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In reply to Wayland • 11:29a, 4/13/20
Wayland said:
Wayland said:
Wayland said:
Wayland said:
Wayland said:
Wayland said:
Wayland said:
Wayland said:
Wayland said:
Wayland said:
https://www.ncdhhs.gov/covid-19-case-count-nc

3/31/2020 Morning DHHS update

NC Cases*
1,498
NC Deaths**
8
Currently Hospitalized
157

4/1/2020 Morning DHHS update

NC Cases*
1584
NC Deaths**
10
Currently Hospitalized
204


4/2/2020 Morning DHHS update (as of 11:00am)

NC Cases*
1857
NC Deaths**
16
Currently Hospitalized
184

4/3/2020 Morning DHHS update (as of 11:25am)

NC Cases*
2093
NC Deaths**
19
Currently Hospitalized
259

Guilford now shows 3 deaths and Mecklenburg 2.

15 deaths > 65 age (20% of positive cases)
2 deaths between 50-64 age (28% of positive cases)
2 deaths between 25-49 age (43% of positive cases)

2919 additional completed tests, 236 positive results for a 8.1% positive test rate day to day.
4/4/2020 Morning DHHS update (as of 11:00am)

NC Cases*
2402
NC Deaths**
24
Currently Hospitalized
271

Looks like DHHS is lagging in numbers today, since we should have had at least 5 more deaths in the morning count. Guilford only showing 3 deaths in this count and they are at 5 or 6. DHHS only reports lab confirmed reported deaths, so maybe the local health departments either aren't reporting or don't have lab confirmation on the media counts?

Congregate Data:
6 Nursing Homes, 4 Residential Care, 2 Correctional Facilities, and 1 Other have 2 more more lab confirmed cases. Considered Outbreak.
4/5/2020 Morning DHHS update (as of 11:00am)

NC Cases*
2585
NC Deaths**
31
Currently Hospitalized
261

Deaths in NC
26 > 65 years of age
3 Between 50-64 years of age
2 Between 25-49 years of age


4/6/2020 Morning DHHS update (as of 11:00am)

NC Cases*
2870
NC Deaths**
33
Currently Hospitalized
270


4/7/2020 Morning DHHS update (as of 10:15am)

NC Cases*
3221
NC Deaths**
46
Currently Hospitalized
354

Worst day. Although some of that total looks to be the lag that the media had that DHHS wasn't reported. 80% of total deaths 65+ years of age.

The highest day for positive cases by collective sample is still 3/23/2020 second highest is 4/1/2020. But positive cases still awful metric since testing is not consistent.
4/8/2020 Morning DHHS update (as of 11:00am)

NC Cases*
3326
NC Deaths**
53
Currently Hospitalized
386
Completed Tests
42987

4/9/2020 Morning DHHS update (as of 11:00am)

NC Cases*
3651
NC Deaths**
65
Currently Hospitalized
398
Completed Tests
47809

Looks like deaths now align with media totals for the morning. 82% of deaths > 65

16 Nursing Homes, 4 Residential Care Facilities, 4 Correctional Facilities, and 1 Other with outbreaks.
4/10/2020 Morning DHHS update (as of 11:00am)

NC Cases*
3908
NC Deaths**
74
Currently Hospitalized
423
Completed Tests
57645

A 2.5% positive test rate is insanely low.

23 Nursing Homes, 6 Residential Care Facilities, 5 Correctional Facilities, and 1 Other with outbreaks.

7 Additional nursing home since YESTERDAY (and 2 additional residential care). Just goes to show you how ineffective this has all been when we aren't actually protecting the most vulnerable. Time for a shift in strategy.
4/11/2020 Morning DHHS update (as of 11:38am)

NC Cases*
4312
NC Deaths**
80
Currently Hospitalized
362
Completed Tests
60393

Hospitalizations down.

Media reporting 84 deaths (so still a gap in reporting there)

2 more Nursing Homes 1 more Residential to add to outbreaks.

4/12/2020 Morning DHHS update (as of 10:45am)

NC Cases*
4520
NC Deaths**
81
Currently Hospitalized
331
Completed Tests
62139

4/13/2020 Morning DHHS update (as of 10:45am)

NC Cases*
4816
NC Deaths**
86
Currently Hospitalized
313
Completed Tests
63,388

Only 1200 more tests but 300 more positives has to be the nursing homes.

WRAL has the state at 95 deaths already. I bet they have a HUGE banner headline celebrating the 100th death.

Still expect some weekend lag in tomorrow's reporting.

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statefan91
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In reply to Wayland • 11:33a, 4/13/20
I don't understand why news stations are maintaining their own counts. Why wouldn't they be going off of official numbers?
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Wayland
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In reply to statefan91 • 11:35a, 4/13/20
statefan91 said:
I don't understand why news stations are maintaining their own counts. Why wouldn't they be going off of official numbers?
Death counts get ratings. If they can report every death first they can get a higher death count first. Theoretically they get them from the counties instead of taking the state's totals. But they also count some cases that aren't officially counted in NC data.

Again watch how they celebrate that epic milestone 100th death. They will be unable to contain themselves.
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Daviewolf83
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In reply to Wayland • 12:00p, 4/13/20
Staff
Wayland said:
statefan91 said:
I don't understand why news stations are maintaining their own counts. Why wouldn't they be going off of official numbers?
Death counts get ratings. If they can report every death first they can get a higher death count first. Theoretically they get them from the counties instead of taking the state's totals. But they also count some cases that aren't officially counted in NC data.

Again watch how they celebrate that epic milestone 100th death. They will be unable to contain themselves.
NC is still in very good shape, but the news media does not want to report this fact. As you said, television (and online as well) is all about eyeballs and you can generate eyeballs by making things seem worse than reality. Here is a fact, at 90 deaths (the last count shown on the Worldometer site), NC ranks in the bottom 10 for total deaths per state when you normalize the data and look at deaths per 1,000,000 people. There are only seven states with lower total deaths per million than NC.

I do expect some bump in the numbers tomorrow, due to the weekend lag we have seen the past couple of weeks, so tomorrow's numbers could be worse. However, total deaths (even if you accept the news media's 93 total deaths) are still well below the numbers forecast for this date by the latest IHME model. For today, it is predicting mean total deaths to be 144 (125 was the prediction yesterday).

Also, hospitalizations continue to decline and this is likely something the media will not point out today. In fact, when you look at the logarithmic curve, the rate of hospitalizations is definitely declining. From a daily new cases standpoint, even with the impact of the outbreaks in nursing homes, the logarithmic plot is almost linear. Once we get past the bubble of these new cases, I expect the daily rate to go completely flat and then start to head down. I still believe new daily cases will peak at the end of the week.

Model Comparison




Hospitalizations Logarithmic Plot




Daily New Cases Logarithmic Plot

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Wayland
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12:05p, 4/13/20
New IHME model gets released today.
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Pacfanweb
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12:06p, 4/13/20
The Louisburg Nursing Center now reports 2 deaths, and the positive count is up to 47.

35 residents and 12 staff.
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RunsWithWolves26
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In reply to Wayland • 12:32p, 4/13/20
Wayland said:
New IHME model gets released today.


Looking forward to seeing what that model says this time.
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acslater1344
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3:07p, 4/13/20
Hospitalizations being down for the 4th straight day is very encouraging. Discharging folks from the hospital at a faster rate than we're admitting them is arguably the most concrete evidence of being on the other side of the peak considering testing data is so limited.
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Wayland
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3:30p, 4/13/20
Reporters are starting to ask much better questions at the governor's press conference. They need to press a little more, but they need to push for more specifics over generalizations.
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Wayland
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3:44p, 4/13/20
Crap. Butner prison has 3 more deaths, all with pre-existing conditions. Will be interesting to see the history of these guys.

Looks like that place is going to send our numbers through the roof. Which is why we need to start seeing the real breakdown of congregate facility cases vs non-facility cases.
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Wayland
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3:56p, 4/13/20
IHME is updated, I don't remember what NC's last expected line was but it is 415 now.

It looks like their death lines increased. Calling 68k now for US.

Watch out though, IHME is going to be releasing some models soon assuming relaxed social distancing. And based on their comments they are going to look rough.
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statefan91
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In reply to Wayland • 4:01p, 4/13/20
  • I looked at it recently and previously they said the US was going to peak on 4/11, so now it's 4/10.
  • For the country, There was a 12k shortage on beds previously, < 4k now
  • North Carolina's peak was moved from 4/15 to 4/17
  • We still have no shortages across vents / beds / ICU beds
  • Projecting 22 deaths today, whereas most days have been < 5. Congregate care places may skew #s. It looks like today is projected peak for deaths though if I'm reading it right
  • I think total deaths is relatively the same, I think it was 416 way out into August prior to the update

Reminder that IHME's model is projected based on us continuing social distancing orders until 6/1: "COVID-19 projections assuming full social distancing through May 2020"

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Wayland
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4:11p, 4/13/20
Even with the June assumption, in the IHME model deaths in NC fall to near zero at the end of April. I don't think this is realistic since we are going to be at a minimum fighting congregate outbreaks or stray active virus in the active population.

Barring any extreme outbreaks, huge congregate spikes, I might put the NC death toll closer to 250 at the end of April (instead of 400) but with continuing low deaths lagging along well into May and beyond.
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RunsWithWolves26
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In reply to statefan91 • 4:23p, 4/13/20
statefan91 said:
  • I looked at it recently and previously they said the US was going to peak on 4/11, so now it's 4/10.
  • For the country, There was a 12k shortage on beds previously, < 4k now
  • North Carolina's peak was moved from 4/15 to 4/17
  • We still have no shortages across vents / beds / ICU beds
  • Projecting 22 deaths today, whereas most days have been < 5. Congregate care places may skew #s. It looks like today is projected peak for deaths though if I'm reading it right
  • I think total deaths is relatively the same, I think it was 416 way out into August prior to the update

Reminder that IHME's model is projected based on us continuing social distancing orders until 6/1: "COVID-19 projections assuming full social distancing through May 2020"



It is good to look at but it has been so far off so often that it's hard to trust it even a little.

Edited to add. They are also predicting 2150 deaths today
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Wayland
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In reply to RunsWithWolves26 • 4:27p, 4/13/20
RunsWithWolves26 said:
statefan91 said:
  • I looked at it recently and previously they said the US was going to peak on 4/11, so now it's 4/10.
  • For the country, There was a 12k shortage on beds previously, < 4k now
  • North Carolina's peak was moved from 4/15 to 4/17
  • We still have no shortages across vents / beds / ICU beds
  • Projecting 22 deaths today, whereas most days have been < 5. Congregate care places may skew #s. It looks like today is projected peak for deaths though if I'm reading it right
  • I think total deaths is relatively the same, I think it was 416 way out into August prior to the update

Reminder that IHME's model is projected based on us continuing social distancing orders until 6/1: "COVID-19 projections assuming full social distancing through May 2020"



It is good to look at but it has been so far off so often that it's hard to trust it even a little.

Edited to add. They are also predicting 2150 deaths today
Barring again another late day spike, we should be around 1,500 again today. -150 from NY/NJ numbers both being down, but that is being counterbalanced by a number of small ticks up on a number of smaller and medium case states (MA, IL, MI).
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statefan91
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In reply to RunsWithWolves26 • 4:32p, 4/13/20
Yeah - wish there was some model that is out that was doing a better job but this seems to be the only one regularly updated that's shared on a larger scale. Truthfully it feels like NC is doing a pretty good job, IHME says 4/17 but there was one produced that Governor Cooper referenced that says something like mid-May.

Not directed at you, but at some point we have to figure out how to live with the virus, protecting and treating as appropriate. We aren't going to eradicate it based on how contagious it is and how little testing we have out there. And a vaccine won't come out for a while.
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RunsWithWolves26
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In reply to statefan91 • 4:33p, 4/13/20
statefan91 said:
Yeah - wish there was some model that is out that was doing a better job but this seems to be the only one regularly updated that's shared on a larger scale. Truthfully it feels like NC is doing a pretty good job, IHME says 4/17 but there was one produced that Governor Cooper referenced that says something like mid-May.

Not directed at you, but at some point we have to figure out how to live with the virus, protecting and treating as appropriate. We aren't going to eradicate it based on how contagious it is and how little testing we have out there. And a vaccine won't come out for a while.


Agree 100%. We've got to learn to live with this and continue life!
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Wayland
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In reply to statefan91 • 4:47p, 4/13/20
statefan91 said:
Yeah - wish there was some model that is out that was doing a better job but this seems to be the only one regularly updated that's shared on a larger scale. Truthfully it feels like NC is doing a pretty good job, IHME says 4/17 but there was one produced that Governor Cooper referenced that says something like mid-May.

Not directed at you, but at some point we have to figure out how to live with the virus, protecting and treating as appropriate. We aren't going to eradicate it based on how contagious it is and how little testing we have out there. And a vaccine won't come out for a while.
https://files.nc.gov/ncdhhs/documents/files/covid-19/NC-Covid-Brief-1-4-6-20.pdf

This is his 'mid-May' one. You can see it peaks in mid-May with the ICU Probability of Exceeding Capacity with maintaining status quo. But the probability charts in that study are unrealistic and based on outdated information. I would love to see their current runs on that 'preliminary and not peer-reviewed' (again that was a from a quote to the media about this) document. No one challenge them to defend any of their conclusions and it is being used to form policy.
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Colonel Armstrong
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In reply to RunsWithWolves26 • 4:48p, 4/13/20
If everything was to open in mid-May.... what defenses do we have to prevent further spread? Warmer weather, 6 feet apart, masks, sanitizer.

Genuine question to the board: do we think that would be enough? Or would we need further measures like limiting building capacity, certain businesses still closed, etc?
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packgrad
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4:50p, 4/13/20
Interesting read.

" Given the data we see across the States and with countries like Sweden, it should not be taboo to question the narrative that wholesale shutdowns were, or at the very least still are, the right approach."


https://medium.com/@yinonweiss/lets-visualize-state-by-state-shutdown-effectiveness-on-covid-19-e13a5cdb50ad
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