NAVIGATING THE SURGE SERIES: Post 1 30,000 foot look at the numbers.


In the past 2 weeks, we have had 1.5 million new infections in the US. That number is probably more like 2-2.5ish million since there is a delay in testing, the incubation period of the virus is 5-14 days, inadequate testing (which is one of the reasons why we have high positivity rates – we aren’t testing enough), and some people will be asymptomatic and not know they are sick. Let’s break down those numbers through pictures.


PICTURE 1: There’s about a 2 week lag between infections and hospitalizations.


PICTURE 2: There’s about a 3 week lag between hospitalizations and deaths.
So, the 1.5-3 million NEW cases of COVID-19 just in the past two weeks are only beginning to show up in the ERs and hospitals.


Ed Yong, one of the best science writers we have, said: “Another way to think about these lags is that some of the people who are infected on Thanksgiving will enter the hospital in the middle of December, and the morgue around Christmas.”

PICTURE 3: What’s the risk of hospitalization and/or death? (Don’t believe the conspiracy theory that is still circulating that 99.998% survive.) At the LOW end CDC estimate of 1-2% case fatality rate (overall among confirmed cases, not broken down by age), that’s 15,000-60,000 deaths among the new infections we have seen over the past 2 weeks. COVID-19 is not the flu – the death rate is 6-10 times higher than the flu. The risk of hospitalizations/death increase by age. Look at the ages 50+.

PICTURE 4: The risk of hospitalization and death increases with certain underlying conditions REGARDLESS of age seen in picture 3.

PICTURE 5: Of those hospitalized and go back home, 1 in 11 may need to be re-admitted.

PICTURE 6: We need to remember that many who are not hospitalized will have long-term symptoms (often called long-haulers of COVID). The median age for these long-haulers is 44 and occur mainly among young, healthy adults. See sources for more on long-COVID symptoms.

Now that we have the numbers and facts in place, let’s talk about what to do to lower our risk in this series.

-Friendly neighbor epidemiologist

SOURCES:

Picture 1 – https://covidtracking.com/

Picture 2 – https://covidtracking.com/

Picture 3 – https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-age.html

Picture 4 – https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html

Picture 5 – https://www.cdc.gov/mmwr/volumes/69/wr/mm6945e2.htm?s_cid=mm6945e2_w

Picture 6 – https://tinyurl.com/y2nomqkj

Ed Yong quote: @edyong209 Twitter feed

Ed Yong’s writings: https://www.theatlantic.com/author/ed-yong/

Case fatality rates: https://ourworldindata.org/mortality-risk-covid?country=~USA

For the Myth Buster series I wrote on how COVID-19 is not the flu (and other debunked myths) go to the pinned post Table of Contents on my page – @friendlyneighborepidemiologist.

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