Many of you know that and believe that and feel that. But, there’s still so much apathy towards this virus and how it affects all of us. I am hearing more and more “I had the virus and am just fine…therefore, open everything up” or “My family had it and are fine…therefore, the cases and deaths are not true”. Goodness gracious, it’s just frustrating. My job as an epidemiologist is to look beyond the individuals to the populations. If something is rare, we pay attention to it but don’t highlight about it daily. However, when the few becomes the many we (epidemiologists) talk about it. With COVID-19, the “many” have shown up for months in daily cases, hospitalizations, and deaths. But, as a nation, we have collectively lost the idea of what’s “normal”. So, let me show you what’s normal.
𝐏𝐈𝐂𝐓𝐔𝐑𝐄 𝟏: 𝐍𝐨𝐫𝐦𝐚𝐥 𝐩𝐨𝐬𝐢𝐭𝐢𝐯𝐢𝐭𝐲 𝐫𝐚𝐭𝐞𝐬 – Remember positivity rates give us an indication if we are testing enough to control the spread. We have become normalized to huge positivity rates – the goal has always been 5% to contain the spread. These levels are attainable. Universities have done that. Other countries have done that. Some counties have done that. So, it’s not like we can’t get there. We just haven’t taken the necessary steps of testing and tracing to do it on a national level.
So, where are we? ONLY 5 states have positivity rates lower than 5% and 4 of those states are increasing. “But, are they testing more? That would cause the higher rates.” No, if we were testing more, the rates would likely go down because we were testing enough. Think of it as little sparks in a fire. If you catch them all, the fire won’t become raging. If you don’t, it can increase to a huge fire – which is what we are seeing. “But, aren’t the new cases in younger people who don’t get as sick?” It doesn’t matter with the higher positivity rates. If those younger people don’t know they are sick (because they weren’t tested), they will go to work, go hang-out with family, and infect high-risk persons…which brings me to picture 2.
𝐏𝐈𝐂𝐓𝐔𝐑𝐄 𝟐: 𝐇𝐨𝐬𝐩𝐢𝐭𝐚𝐥𝐢𝐳𝐚𝐭𝐢𝐨𝐧𝐬
Picture 1 told us how bad the new cases are (and will be) because we aren’t testing enough. Picture 2 tells us about our healthcare systems. What is normal? Being in the green. This should be normal and could have been attainable. It still is if we would just wear a mask and take this seriously. So, where are we? I think we have all become normalized to just seeing a red/maroon map by now. But what that means on the ground is that hospitals are preparing or are having to do surge capacity (which has limits), tent hospitals, are dealing with staffing shortages, and lack of beds. Our hospitals are heroes – but, they are not full of infinite resources and are tired. Here in Texas, I saw where Lubbock is completely out of beds. In my McLennan County, we have the highest hospitalization rates we have had in this pandemic – magnitudes higher than what we saw in the summer surge. “But isn’t this normal? We see hospitalizations high like this with the flu, right?” No, let me show you.
𝐏𝐈𝐂𝐓𝐔𝐑𝐄 𝟑 – 𝐓𝐡𝐢𝐬 𝐬𝐡𝐨𝐰𝐬 𝐭𝐨𝐭𝐚𝐥 𝐡𝐨𝐬𝐩𝐢𝐭𝐚𝐥𝐢𝐳𝐚𝐭𝐢𝐨𝐧𝐬 𝐟𝐨𝐫 𝐭𝐡𝐞 𝐟𝐥𝐮 𝐟𝐨𝐫 𝐭𝐡𝐞 𝐩𝐚𝐬𝐭 𝟏𝟓 𝐲𝐞𝐚𝐫𝐬. The blue bars show people who visited the ER for the flu but went home and the green bars show the people who were admitted. If you look at the worst year of 2014-2015, there were a TOTAL of 223,000 people hospitalized in-patient with the flu for the entire flu season. Where are we with COVID-19?
𝐏𝐈𝐂𝐓𝐔𝐑𝐄 𝟒 – 𝐓𝐨𝐭𝐚𝐥 𝐡𝐨𝐬𝐩𝐢𝐭𝐚𝐥𝐢𝐳𝐚𝐭𝐢𝐨𝐧𝐬 𝐟𝐨𝐫 𝐂𝐎𝐕𝐈𝐃-𝟏𝟗 We reached total hospitalizations of 100,000 in one day yesterday. One.Day. Not the full season like in Picture 3. I don’t think it’s hard for you to see that 100,000 at one DAY is different than 223,000 in an ENTIRE SEASON. “But, what if the 100,000 are repeat hospitalizations?” In older populations, the data shows that 1 in 11 are repeat hospitalizations, so it wouldn’t make that much of a difference with a number as high as 100,000. All ages are being hospitalized with COVID-19 too.
✅ 𝐒𝐨, 𝐰𝐡𝐚𝐭’𝐬 𝐭𝐡𝐞 𝐬𝐮𝐦𝐦𝐚𝐫𝐲? We need to get back to the reality of this situation – we need to de-normalize the massive positivity rates, case numbers, and hospitalization rates we are seeing – we have become (as a nation) de-sensitized to red/maroon maps as normal. It’s just not. And, it’s getting worse. On the ground, the red/maroon indicate lots and lots of sickness and suffering.
✅ 𝐒𝐨, 𝐰𝐡𝐚𝐭 𝐝𝐨 𝐰𝐞 𝐝𝐨? We stay home. We wear a mask and distance. We don’t go to indoor gatherings (any of them). Don’t do indoor dining (do take-out and leave a good tip), don’t go to indoor church (church leaders, please lead the way and move to fully online), don’t have holiday parties. We don’t use excuses of conspiracy theories floating around about “I’ve never worn a mask (from the Oregon doctor)” to “The deaths are not that bad (from the Hopkins professor)”. These are grasping for excuses to not take this seriously. These excuses provide no protection against COVID-19 to ourselves or spreading it to others.
I know we are all tired of this. Some are tired of the emotional weight, the economic weight, the physical weight of it. Pandemic fatigue is real. But, sticking our heads in the sand to the gravity of the situation will only make it worse. What we need is all-hands-on-deck in solidarity for our communities and hospitals. We have vaccines right around the corner. But, what we do today matters to get everyone around that corner safely. This.Is.Not.Normal.
-Friendly neighbor epidemiologist
Pictures 1 and 2 https://www.covidexitstrategy.org/
Picture 4 https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html?name=styln-coronavirus®ion=TOP_BANNER&block=storyline_menu_recirc&action=click&pgtype=LegacyCollection&impression_id=c1de1b12-3634-11eb-abc6-d3ef61334bca&variant=1_Show