One thing I'll never understand is why 18-24 year olds are reported together and then 25-49 is the next range. Does it not make more sense to report as 0-10, 11-20, 21-30, etc?

Those with chronic conditions 12x more likely to die, and much more likely to need admission. Most common are CV dz, pulmonary dz, and diabetes.

Part of me has been wondering if we weren't going to see a spike 2-3 weeks out from the Phase 2 as the virus found its next set of soft spots and then it settled back down a little after it sniped its first round of new soft targets. Hopefully can wrestle some control back.

Idk, maybe so. But looking at that data is very telling to me. Still useful stuff imho

Totally agree. Knew there'd be a spike, but the difficulty is that I'm not sure there are soft spots. For death and severe illness, sure, but for transmission, no. Bottom line, we need an effective vaccine asap. I'm ready to get my life back.

I really want to address PackMom's serology question. It was a good one, so I'll try to get to that in a while. I'll address the current limitations and guidelines/ recommendations as best I can

At least still in your data we are seeing a relatively stable admit rate and not a steady rise. I hope every day to see a decline and it is frustrating to no end not to be there.

I am certainly no epidemiologist and I am not speculating on an individual's susceptibility to contract the virus. I am assuming equal susceptibility and not even considering outcome.

Rather on the infected who have a high number of contact points and the potential to spread across communities or isolated groups. The more these high contact points can be protected or achieve resolution, the harder it will be for the virus to spread.

Which why testing LTC, food processing, etc., over and over is a good thing. Keep trying to catch the cases early before they hit the rapid spread point.

Watching Meck and Guilford death totals creep up since yesterday. Wonder if it is backlog or new.

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6/1/2020 Morning DHHS update (as of 11:00am)

NC Cases*
29,263
NC Deaths**
898
Currently Hospitalized
650
Completed Tests
421,908

559 Deaths are now Congregate (+7)
72 Deaths are now Unknown Setting (+1)
+12 Deaths Overall since yesterday.

267 Deaths assumed General Population (+4)
631 Congregate and Unknown Setting. (+8)

162 Congregate Facilities now have an outbreak. (+2)

WRAL is at 923 (+2) and NandO is at 944 deaths

674 positive cases over 5619 new tests. 12.0% positive rate.

3 of the deaths reported by DHHS today are over 10 days old. Expect a spike in hospitalizations tomorrow, hospitals have been slack in reporting on the weekends.

---

6/2/2020 Morning DHHS update (as of 12:00pm)

NC Cases*
29,889
NC Deaths**
921
Currently Hospitalized
716
Completed Tests
434,921

574 Deaths are now Congregate (+15)
76 Deaths are now Unknown Setting (+4)
+23 Deaths Overall since yesterday.

271 Deaths assumed General Population (+4)
650 Congregate and Unknown Setting. (+19)

163 Congregate Facilities now have an outbreak. (+1)

WRAL is at 933 (+2) and NandO is at 961 deaths

626 positive cases over 13,013 new tests. 4.8% positive rate.

DHHS is now releasing updates at noon instead of 11am. Apparently they need an extra hour to process increased testing data. Tough decisions on what data to release on what day to support narratives.

There is that jump back in hospitalizations I called yesterday now that most of them are reporting again.

5 of the deaths reported today occurred over a week ago. The remaining 17 all fall between 5/27-6/1.

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6/3/2020 Morning DHHS update (as of 12:00pm)

NC Cases*
30,777
NC Deaths**
939
Currently Hospitalized
684
Completed Tests
449,263

585 Deaths are now Congregate (+11)
80 Deaths are now Unknown Setting (+4)
+18 Deaths Overall since yesterday.

274 Deaths assumed General Population (+3)
665 Congregate and Unknown Setting. (+15)

163 Congregate Facilities now have an outbreak. (+0)

WRAL is at 952 (+2) and NandO is at 980 deaths

888 positive cases over 14342 new tests. 6.2% positive rate.

Every day for the last 8 days contains at least 1 death reported in today's total.

26 of the deaths reported by the media but not reported by DHHS are coming from three counties.
Carteret - DHHS 3, NandO 9, County - 3
Robeson - DHHS 14, NandO 26, County - 22
Alamance - DHHS 20, NandO 28, County - 23

Media reporting that unfortunately, NC has had its first death of a minor due to COVID-19 complications.

---

6/4/2020 Morning DHHS update (as of 12:00pm)

NC Cases*
31,966
NC Deaths**
960
Currently Hospitalized
659
Completed Tests
468,302

598 Deaths are now Congregate (+13)
79 Deaths are now Unknown Setting (-1)
+21 Deaths Overall since yesterday.

283 Deaths assumed General Population (+9)
677 Congregate and Unknown Setting. (+12)

167 Congregate Facilities now have an outbreak. (+4)

WRAL is at 963 (+2) and NandO is at 997 deaths

1189 positive cases over 19039 new tests. 6.2% positive rate.

Big case day, massive number of tests. Hospitalizations down (85% reporting vs 88% yesterday). Most of the cases are from Monday, maybe they are getting a little quicker at reporting.

Based on my daily tracking of deaths by date starting 5/7. Three of the death reported today either were not added to the DHHS graph or occurred greater than a month ago. 1 is from 5/21 and the remainder are from within the last week.

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6/5/2020 Morning DHHS update (as of 12:00pm)

NC Cases*
33,255
NC Deaths**
966
Currently Hospitalized
717
Completed Tests
482,147

602 Deaths are now Congregate (+4)
78 Deaths are now Unknown Setting (-1)
+6 Deaths Overall since yesterday.

286 Deaths assumed General Population (+3)
680 Congregate and Unknown Setting. (+3)

171 Congregate Facilities now have an outbreak. (+4)

WRAL is at 1004 (+2) and NandO is at 1006 deaths

1289 positive cases over 13845 new tests. 9.3% positive rate.

More high case day. Maybe this will be the weekend dump early. Still wondering about the 40 gap in deaths. I wonder if there is something to probably vs confirmed cases. Whatever. Will get there eventually.

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6/6/2020 Morning DHHS update (as of 12:00pm)

34,625
NC Deaths**
992
Currently Hospitalized
708
Completed Tests
497,350

621 Deaths are now Congregate (+19)
79 Deaths are now Unknown Setting (+1)
+26 Deaths Overall since yesterday.

292 Deaths assumed General Population (+6)
700 Congregate and Unknown Setting. (+20)

176 Congregate Facilities now have an outbreak. (+5)

WRAL is at 1032 (+2) and NandO is at 1028 deaths

1370 positive cases over 15203 new tests. 9.0% positive rate.

Biggest day of positive 'reported' cases. Deaths continue to be driven by congregate facilities.

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6/7/2020 Morning DHHS update (as of 12:00pm)

NC Cases
35,546
NC Deaths
996
Currently Hospitalized
696 <- only 76% hospitals reporting
Completed Tests
511,226

623 Deaths are now Congregate (+2)
80 Deaths are now Unknown Setting (+1)
+4 Deaths Overall since yesterday.

293 Deaths assumed General Population (+1)
703 Congregate and Unknown Setting. (+3)

171 Congregate Facilities now have an outbreak. (-5)

WRAL is at 1038 (+2) and NandO is at 1028 deaths

921 positive cases over 13876 new tests.6.6% positive rate.

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6/8/2020 Morning DHHS update (as of 12:00pm)

NC Cases
36,484
NC Deaths
1006
Currently Hospitalized
739 <- new high. still only 77% reporting. Need to watch.
Completed Tests
520,113

634 Deaths are now Congregate (+11)
78 Deaths are now Unknown Setting (-2)
+10 Deaths Overall since yesterday.

294 Deaths assumed General Population (+1)
712 Congregate and Unknown Setting. (+9)

171 Congregate Facilities now have an outbreak. (+0)

WRAL is at 1053 (+2) and NandO is at 1041 deaths

938 positive cases over 8887 new tests. 10.6% positive rate.

5 of the deaths added today to the Death by Date chart at DHHS were from over 2 weeks ago. It did make the single highest fatality date to be 5/25 with 27 deaths.

7 of the additional death added to the daily total today appear to have come out of Chatham County. Looks like they had some paperwork reconciliation.

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6/9/2020 Morning DHHS update (as of 12:00pm)

NC Cases
37,160
NC Deaths
1029
Currently Hospitalized
774 <- new high. still only 84% reporting. Expected increase with higher reporting. Stable from ystday
Completed Tests
535,711

647 Deaths are now Congregate (+13)
79 Deaths are now Unknown Setting (+1)
+23 Deaths Overall since yesterday.

303 Deaths assumed General Population (+9)
726 Congregate and Unknown Setting. (+14)

177 Congregate Facilities now have an outbreak. (+6)

WRAL is at 1068 (+2) and NandO is at 1068 deaths

676 positive cases over 15,598 new tests. 4.3% positive rate.

Congregate spread continues.

Side note of the day: NY has stopped reporting deaths in their daily briefing because the number is not "significant anymore" since most of the deaths are things like "covid and heart disease". NY reported 74 COVID deaths yesterday. 3 times NC's worst day, but now their daily deaths don't matter. Has to be nice to kill so many that it doesn't matter anymore.

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6/10/2020 Morning DHHS update (as of 12:00pm)

NC Cases
38,171
NC Deaths
1053
Currently Hospitalized
780 <- new high. but higher reporting %. stable
Completed Tests
553,650

661 Deaths are now Congregate (+14)
83 Deaths are now Unknown Setting (+4)
+24 Deaths Overall since yesterday.

309 Deaths assumed General Population (+6)
744 Congregate and Unknown Setting. (+18)

182 Congregate Facilities now have an outbreak. (+5)

WRAL is at 1079 (+2) and NandO is at 1089 deaths

1011 positive cases over 17939 new tests. 5.6% positive rate.

As of yesterday ~36 Congregate Facilities were out of the outbreak stage. They are not included in the active outbreak count.

22 of today's reported death are from June. 1 reported death is from 5/8. 1 reported death is either prior to 5/7 or not reflected on the DHHS graph.

Testing % positive has been trending back down.

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6/11/2020 Morning DHHS update (as of 12:00pm)

NC Cases
39,481
NC Deaths
1064
Currently Hospitalized
812 <- new high.
Completed Tests
572,677

666 Deaths are now Congregate (+5)
86 Deaths are now Unknown Setting (+3)
+11 Deaths Overall since yesterday.

312 Deaths assumed General Population (+3)
752 Congregate and Unknown Setting. (+8)

181 Congregate Facilities now have an outbreak. (-1)

WRAL is at 1108 (+2) and NandO is at 1106 deaths

1310 positive cases over 19027 new tests. 6.9% positive rate.

New high in hospitalizations. WE NEED DAILY CENSUS DATA

Strangest Day on for Day of Deaths. 2 deaths were REMOVED from the total from 6/3 and 6/5. 16 other deaths were added from between 5/28-6/9 which means 1 other death which wasn't previously accounted for on the day of death chart has been added. Odd.

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6/12/2020 Morning DHHS update (as of 12:00pm)

NC Cases
41,249
NC Deaths
1092
Currently Hospitalized
760
Completed Tests
595,697

Congregate incomplete due to DHHS not refreshing data.
-----------------------------------------------------------------------------------------
689 Deaths are now Congregate (+23)
88 Deaths are now Unknown Setting (+2)
+28 Deaths Overall since yesterday.

315 Deaths assumed General Population (+3)
777 Congregate and Unknown Setting. (+25)

181 Congregate Facilities now have an outbreak. (0)
------------------------------------------------------------------------------------------

WRAL is at 1147 (+2) and NandO is at 1121 deaths

1768 positive cases over 23020 new tests. 7.6% positive rate.

Wow. Cases even higher than I would have thought. Media will have a field day with this Friday data.

Will updated congregate data when site updates.

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6/13/2020 Morning DHHS update (as of 12:00pm)

NC Cases
42,676
NC Deaths
1104
Currently Hospitalized
823 <- new high
Completed Tests
611,690

-----------------------------------------------------------------------------------------
698 Deaths are now Congregate (+9)
87 Deaths are now Unknown Setting (-1)
+12 Deaths Overall since yesterday.

319 Deaths assumed General Population (+4)
785 Congregate and Unknown Setting. (+8)

181 Congregate Facilities now have an outbreak. (0)
------------------------------------------------------------------------------------------

WRAL is at 1153 (+2) and NandO is at 1121 deaths

1427 positive cases over 15,993 new tests. 8.9% positive rate.

Of the deaths added today, 6 were from this past week. 1 was from 6/1, 1 from 5/29, 1 from 5/26, 2 from 5/25, and 1 prior to 5/7 or unaccounted for.

Death totals are MOSTLY complete after 7 days (based on what I have seen in my spreadsheet)

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6/14/2020 Morning DHHS update (as of 12:00pm)

NC Cases
44,119
NC Deaths
1109
Currently Hospitalized
798 <- 76% reporting down from 84%
Completed Tests
627,130

-----------------------------------------------------------------------------------------
700 Deaths are now Congregate (+2)
89 Deaths are now Unknown Setting (+2)
+5 Deaths Overall since yesterday.

320 Deaths assumed General Population (+1)
789 Congregate and Unknown Setting. (+4)

187 Congregate Facilities now have an outbreak. (+6)
------------------------------------------------------------------------------------------

WRAL is at 1162 (+2) and NandO is at 1127 deaths

1443 positive cases over 15,440 new tests. 9.3% positive rate.

All 5 deaths reported today are from the last 5 days.

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6/15/2020 Morning DHHS update (as of 12:00pm)

NC Cases
45,102
NC Deaths
1118
Currently Hospitalized
797 <- 73%
Completed Tests
638,479

-----------------------------------------------------------------------------------------
706 Deaths are now Congregate (+6)
90 Deaths are now Unknown Setting (+1)
+9 Deaths Overall since yesterday.

322 Deaths assumed General Population (+2)
796 Congregate and Unknown Setting. (+4)

187 Congregate Facilities now have an outbreak. (0)
------------------------------------------------------------------------------------------

WRAL is at 1164 (+2) and NandO is at 1132 deaths

983 positive cases over 11,349 new tests. 8.7% positive rate.

Dates of deaths today 5/29 -1, 6/5 - 1, 6/7 - 1, 6/11 - 2, 6/12 -1, 6/13 -2, 6/14 - 1.

Ethnicity
Hispanic - + 264 cases
Non-Hispanic - +158 cases
Unknown - +561 cases

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6/16/2020 Morning DHHS update (as of 12:00pm)

NC Cases
45,853
NC Deaths
1154
Currently Hospitalized
829 <- 85% still stable since increased from 73% yesterday reporting
Completed Tests
651,421

-----------------------------------------------------------------------------------------
723 Deaths are now Congregate (+17)
97 Deaths are now Unknown Setting (+7)
+36 Deaths Overall since yesterday.

334 Deaths assumed General Population (+12)
796 Congregate and Unknown Setting. (+24)

193 Congregate Facilities now have an outbreak. (+6)
------------------------------------------------------------------------------------------

WRAL is at 1196* and NandO is at 1169 deaths

751 positive cases over 12,942 new tests. 5.8% positive rate.

And there is the massive death dump I was expecting. Only 2 of the deaths are from before June. The rest fills in over the last 2 weeks with 21 of them coming in the last 4 days. So mostly current.

Thanks caught an error I had. Looking at your graph and comparing with my data, 2 of the deaths are either prior to 5/7 or unaccounted for on the graph.

Of the deaths today 5 from Meck, 4 from Guilford, No other county had more than 2.

Looks like at least another 4 deaths are going to hit out of Guilford tomorrow. They have less than 300 TOTAL hospitalizations to date and 99 deaths. Hard hit.

Guilford has had the same number of deaths since May 29th as Wake has had total through all this.

PackMom said:

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What do you think about the IgG tests? Are they accurate enough to put any confidence in them? I've read there are a number o different tests with varying accuracy, and that you could come up with a false positive due to having antibodies to a different coronavirus. I'd be disinclined to make any behavioral decisions based on the results.

---

You, my lady, are exactly correct. The serology tests have significant limitations. Because dz prevalence is presumed low, the rate of false positives will be higher. Cross-reactivity with other viruses is an issue, also increasing the false positive rate. And we simply don't know how much immunity IgG gives us, ie how strong is the immunity and how long will it last? So using a positive IgG test to drive policy or offer a false sense of security to return to work or pretend it's ok to stop with preventative behaviors would not be advisable at this point. Additionally, many of the current testing methods simply don't have FDA approval at this point. The ama keeps a list of the approved ones.

Personally, a negative PCR only gives me moderate confidence I don't have C19 the day I'm tested but means very little the next day, a positive PCR tells me I most likely have C19, and a positive IgG tells me maybe I was exposed at some point but I still need to use current protective guidelines. But that's just me, and it's what I recommend to my friends/fam.

1. Absolutely plausible. In fact, most likely probable. As with all viral exposures, there will be those that are asymptomatic carriers and or have such low viral loads for various reasons that they remain asymptomatic.

2. Monoclonal abs are hot right now because they can be produced in large quantities, can offer passive or active immunity, target specific cell receptors or proteins, can treat or prevent dz, reduce risk of transfusion reactions or fluid overload, and have proven effective for c diff, rsv, anthrax and Ebola to a degree. Would be a great potential answer to prevent illness in cluster situations/ potential outbreak facilities. Buys time for vaccine development. Downsides: will they confer immunity, what dose is needed, how do you effectively study outcomes in this population where so many recover or may remain asymptomatic anyway, will they actually ENHANCE viral activity??? Yes, they can do that or they can bind to the virus to form an ab-viral complex that incites cytokine release to increase inflammation/ destruction.
3. I think it's just better immune response, better physiology, less concomitant disease burden.

Mormad, thanks for your answer on the antibody tests. What are your thoughts about the MMR somehow conferring some resistance to the younger group? Those of us who had the diseases instead of the vaccine don't get any help from our leftover immunity, but I guess it fades as we age.

Can you be too old to take the MMR vaccine?
Are there co-morbid conditions that would preclude one from taking the vaccine?

Positive test confirmed. Still feeling okay, though.

Saw this from Dr. Birx today from the task force call with governors:

"Birx did explain that because of an increase in testing, more cases, including asymptomatic and presymptomatic cases, are being found in the community, rather than in hospitals.
"So, I don't ever get discouraged that the case numbers are going up when you're test positivity rate is going down. Really an extraordinary job you're doing and I think you should be commended for that. We do have isolated counties, and I'm just gonna mention a couple of them," she said.
Birx said that North Carolina's Wake County and Mecklenburg County, where the Republican National Convention was scheduled to be held later this summer, were experiencing increased positivity."

Yikes..

What caused the lack of testing relative to other states? Any ideas?

acslater1344 said:

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Positive test confirmed. Still feeling okay, though.

Saw this from Dr. Birx today from the task force call with governors:

"Birx did explain that because of an increase in testing, more cases, including asymptomatic and presymptomatic cases, are being found in the community, rather than in hospitals.
"So, I don't ever get discouraged that the case numbers are going up when you're test positivity rate is going down. Really an extraordinary job you're doing and I think you should be commended for that. We do have isolated counties, and I'm just gonna mention a couple of them," she said.
Birx said that North Carolina's Wake County and Mecklenburg County, where the Republican National Convention was scheduled to be held later this summer, were experiencing increased positivity."

Yikes..

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Sorry to hear about the positive test brother....hope everything goes ok.

The problem I have with the comment about increased positivity of test is that Mandy Cohn said during one of the press conferences earlier this week that the state was focused on testing people that were more likely to test positive. Seems to me that if you were going to make a effort to test that segment of the population then your results would reflect that. It also seems to me that we should be taking a cross section of people and then analyzing the results, not just cherry picking folks that will give you the results that will justify the governors next steps

Or at least bifurcate it - i.e., general pop % is actually 4.5%, congregate care is 10.9%. Hot spots account for 1.7% of general pop %, etc.

Exactly. All that information is important. As are finding cases, but present the data in a meaningful sense.

On a side note, having a tough time reading the pre-DHHS data this morning. I am expecting another heavy death counting day (more mid-week housekeeping?)

Cases, not sure what to read today. DHHS had been running up to 500 cases higher than Meck was reporting on their site for Meck county. They are only 100 higher now, so either Meck is catching up (and there will be about 200 cases out of them today) or they just took a large case dump and it will be closer to 400. I guess we will see.

On a side note Meck was actually down in yesterday's reporting in overall cases (but that could just be reporting differences) from 214->193 total and down 5 ICU. The difference however was made up in a bump in Duke, Mid Carolina, and Triad.

Overall ICU remained below 300 a little higher, but there was additional reporting, so tough to figure. Still want it to start trending down... and not stay flat.

Saw data today suggesting kids less than 20 are half as susceptible to infection after exposure and only 21% in the study showed symptoms vs 69% in older adults. Nothing groundbreaking as to WHY this is observed.

I have serious doubts that a decision to focus on testing those that are most likely to test positive is to justify the gov's next steps. I think this type of thinking is where I deviate most from those here.

packgrad said:

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As I begin the end of week sipping, the frustration of testing negative for antibodies increases. I have been in the quarantine Petrie dishes (Home improvement stores and grocery stores) multiple times every work day since this quarantine started. Literally every day. No off days Monday-Friday. With and without masks It was impossible to find them early. Multiple times a day, Raleigh, Durham, Chapel Hill, Wake Forest, Cary, Mebane, Burlington, Greensboro. I question how contagious this virus is, or question how much it has hit NC.

I'm quite frustrated that we have shut down society, aside from a few spots where we allow everybody, that I frequent all the time, and I haven't been exposed. How is that possible?

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I just got my antibody result back and it said negative as well. I haven't been out as much as above, but I also haven't been a shut-in.

Mormad said:

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Saw data today suggesting kids less than 20 are half as susceptible to infection after exposure and only 21% in the study showed symptoms vs 69% in older adults. Nothing groundbreaking as to WHY this is observed.

I have serious doubts that a decision to focus on testing those that are most likely to test positive is to justify the gov's next steps. I think this type of thinking is where I deviate most from those here.

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I don't know that it is some sort of master nefarious plot. Cooper doesn't come off as a 'numbers guy' to me and by his reaction to some of the questions, I think a lot of what is going on is over his head (data related). He is a politician and has that working against him.

But I do know that the state is hiding numbers that they have at their fingertips.

It is like when dealing with children. When you ask simple questions and they respond with oddly vague answers, it doesn't mean they are trying to hide something but it gives you that sense. There is no reason to hide the information they have. It certainly shows some concerning trends in some areas but it also shows things are relatively stable in other areas. Especially hearing how questions on data are answered at briefings knowing they have concrete answers regarding numbers and they feign to be uncertain.

At this point I have less and less faith in the overall hospitalizations because of what appears to be inconsistencies in how 'non-critical' cases are being counted between hospital groups. And oddly disproportionate 'suspected' COVID counts coming out of 1 or 2 hospital groups.

ICU is a different story and I think paints a much clearer picture. And that picture isn't improving from a total ICU admits scenario. So there should be hyper focus there. Again, along side daily admits/recoveries so we can see the flow not just the surface.

My take is DHHS is just bad with data. Cohen, I think, is actually better than most but tries to dumb it down too much and explains it to the media like they are children (they are). She should talk past them and put it out to the people themselves to understand.

Dr Cohen just said that hospitalizations will be at 849 todaynew high.

Daviewolf83 said:

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Mormad - While you are around, I did have a few questions that hopefully you can answer.


3. Have you seen anything in recent medical papers to suggest why kids and people under the age of 24 seem to have much better outcomes than people in the older age groups? Could it be that people under the age of 24 likely have fewer pre-existing conditions than older age groups or is there something else that makes the virus less fatal for them?

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Of course Mormad knows more about this than the rest of us, but I'd think that the reason young people are less susceptible to Covid is the same reason they are less susceptible to all other viruses and sicknesses:

They are young. Stronger and more robust immune symptoms, and they have fewer things wrong with them that might make them have a difficult time fighting it off.

Ncstatefan01 said:

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Dr Cohen just said that hospitalizations will be at 849 todaynew high.

---

Missed the beginning of the QandA did she give any other stats?

Media will get a headline. Hopefully it is also a high reporting hospital number. They need to provide the ICU number alongside.

Bummer, if things don't turn around soon, we will be stuck here in Phase 2 for a while. Need to keep catching these hot spots and keep cases down.

And Cohen just admitted that they were hoteling nursing home patients in hospitals, in answering that there are LTC facilities volunteering to take these patients from hospitals.