In March, the total number of COVID-19 infections paused their descent from the winter peak, and began to turn upward towards the start of another possible inflection point. Back then we wondered what lay ahead – and today we are still unsure.
COVID-19 mortality
The COVID-19 pandemic remains in the nightly news and is always there in our daily lives. Charts, tables, and statistics dominate the discussion; some emphasize counts and quote short-term percentage changes such as a 20% drop in hospitalization. Statistics and pictures may tell COVID-19 stories, but the message may depend on how you look at them. Here we present some examples and discuss the various lessons to be learned.
The popular press is replete with descriptive data on the current pandemic on global and national scales and for selected local areas with extreme outcomes. Here we describe regional data from April through December 2020 and analyze commonality among regions, case-fatality rates, and rates of change among daily rates, including "flattening of curves." We hope to Improve understanding of regional differences and trends in the pandemic.
Our elderly population living in nursing homes has been a target of COVID-19 and now early vaccination. Was COVID-19 preying upon the weak and frail -- where some co-morbidities more likely to be problematic -- or were nursing home protocols, and the staff administering them, one of the Horsemen of the Apocalypse?
COVID-19 infections are relentless. In every state, November rates increased over October, more than doubling on average. And these rates are widely dispersed across the nation. Early COVID-19 cases and deaths were associated with local conditions, including residential crowding and household income. More personal factors have since come into play as the pandemic spread and hotspots shifted to the heartland.
The media reports of national COVID-19 statistics mask the substantial and continuing variations among regions. The virus doesn't care about geography, but we need to understand geographic differences if it is to be contained.
As we move towards social mingling, the official mantra is the three T’s, testing, track, and tracing. There are two bottlenecks, first having enough reliable tests; second, having the labor force, human or technological, to do the tracking. While the process of track and trace remains under development, testing is increasing and is frequently now a daily metric by government officials.
To understand how severe and lethal COVID-19 really is, we need to know how many have been infected, which, in this equation, is the "denominator." An early study from Stanford of Santa Clara County says we may be underestimating how many cases there already are, which inaccurately gauges COVID-19’s infectivity and eventual mortality.
"Although the epidemiology of COVID-19 is evolving, we have determined that there is a large overlap between causes of deaths of COVID-19 patients and the diseases that are affected by long-term exposure to fine particulate matter (PM2.5).”
It is a great leap from overlap to claiming PM2.5 results in "excess" mortality from COVID-19. But what the heck, why let the fear generated by COVID-19 go to waste?
An occasional feature where a picture is indeed worth a thousand words.