It’s the middle of the summer, and the coronavirus has not gone away. When the pandemic first began, we hoped that there’d be a lull during the summer, with the heat knocking it out, but this hasn’t happened.
Arguments have also become part of the daily discourse, with people debating over case counts and death tolls, how the trends should be interpreted and whether the reported numbers can even be trusted.
It is also concerning to witness local and national leaders, using data out of context to justify their own narratives. At the same time, the public is sincerely confused, trying to find a way through all the numbers and charts being thrown around, asking: “How concerned should I be right now? How bad are things, really?”
Indeed, the rapid spread of the coronavirus across the United States has been met with a decentralized and piecemeal response – forced into the hands of governors, mayors and local health departments. The current administration’s coronavirus response has aggravated the pandemic with uneven assistance to states, funding and supply delays, inconsistent messaging, and insufficient testing. While mistakes are inevitable in the face of such a massive and rapidly evolving domestic and global challenge, our federal government’s response compares unfavorably to a number of other countries, many of whom faced the virus before we did.
We are all impacted by COVID19. Some of us more so than others – due to individual, community or geographical circumstances. Most of us are fatigued and frustrated. Months of isolation have taken its toll. The one thing that surely must cut across all of this is being overwhelmed with the constant influx of information and misinformation. We are flooded by varying sets information.
In this article, I attempt to decipher and simplify the data into useful and practical tidbits. The goal is that this may help guide you in developing an educated approach to the pandemic.
The number of cases
“The number of cases” – represent the number of people who have tested positive for coronavirus. We see record numbers – most recently on the order of 50,000 per day. But we’re told that this is influenced by an increased number of tests being performed. The White House uses various justifications to say that we simply shouldn’t test as much – and that would solve the problem. This is flawed for many reasons – but for now don’t let this confuse the issue. The simple fact is that more testing means more positive tests.
We know that the number of cases on record is an underrepresentation of the true burden – for several reasons. Some underrepresentation is because testing might not be available for an infected person. Another factor is that not everyone who is positive will need to see a physician for treatment. The WHO published a very detailed analysis on this topic. It stands to reason that if someone gets infected and recovers on their own, then public health may not find out about the case.
Another consideration is that the numbers reported today actually “lag” behind present-day disease. From the time someone is exposed and becomes infected until he is clinically sick (and presents to the hospital) is roughly fourteen days. This means that there are a population of infected people who remain unidentified. What we see today as the number who are infected is not necessarily representative of the virus as it exists in the community today.
The bottom line is that test results are a tool that helps drive an intelligible national response. Testing is a very important tool in dealing with the pandemic. It provides a window of how COVID is evolving. By utilizing the science, we are able to balance public health and welfare with economic factors.
What statistics are most practical to you?
There are two statistics that provide us a reliable approximation of where each of us stand with COVID. The first is the positivity rate. The second is the number of deaths per day.
Positivity Rate
Positivity rate is very useful. It references the number of tests coming back positive as a ratio. We look at the ratio of positive tests/total number of tests.
By taking a ratio, the data is somewhat normalized. While this number will trend downward as more tests occur, we need not consider this factor for the present purpose.
This ratio informs us of the “disease transmission.” If this number stays constant, it likely means that the virus is somewhat stable. Stable is defined as there being no increase in disease transmission. On the other hand, if there is more disease transmission, then the positivity rate goes up. In fact, that is what we’re seeing in large parts of the country right now.
The overall trend in positivity rate (disease transmission) provides us a sense of which direction the country and specific regions are heading in. For instance, recently in Florida and Arizona, the positivity rate has been above 20%. According to the WHO, this number is very high. By comparison, the WHO recommends that the positivity rate should be less than 5% prior to reopening of a state.
By way of example, in Massachusetts the daily positive case counts have been falling, while at the same time the daily positivity rate is now under 2%. These numbers justify less vigilance on the part of each of us. It means that we can step outside, exercise, go food shopping, while at the same time exercising due caution.
Number of Deaths
This number is perhaps the most revealing statistic. It is worthwhile to make note and follow this trend.
The number of deaths is absolute. It is not dependent on or confounded by the number of tests or the number of positives. It is a direct indicator of where the country and specific regions stand. If this number is on the high end, it suggests that you should exercise increased caution in your daily activities. If there are less deaths, it may be safer to journey outward.
In the absence of consistent information from the federal government on hospitalizations and other metrics, deaths can be a more reliable indicator of the burden of illness in a population.
Most recently, the national number has been near-constant at 1000 deaths per day.
Conclusion
We are all also experiencing multiple stages of panic, paranoia, fear, uncertainty and frustration.
The virus is remains with us. It is alive and well.
Becoming derailed by the confusing messages is easy to do. COVID remains a serious illness. Most often the illness is more serious than being “just the sniffles.” While fatality favors the older and those with certain co-morbidities, we’ve witnessed seemingly healthy young and middle-aged patients suffer gravely.
In spite of the issues at hand, the difficulty in maintaining focus in the setting of being weary, it is worthwhile to remain vigilant and with your guard up.
Complacency may be harmful.
Do not get complacent. Continue to apply practicality and common sense. Continue to wash hands more frequently, avoid crowded spaces. Maintain social distancing.
Many of us must earn a living and therefore must leave the house. Exit with with caution.
Identify and acknowledge your priorities (perhaps in a list). Make sure that – somewhere on your list – you include “your own survival.” Contracting the coronavirus may threaten your survival if you’re older and/or have a history of medical illness.
Factor in also those who live in and around you. Their survival should be considered as well. If you contract the virus, you may potentially pass it off to your loved ones. If you do, who can step in your shoes and support the household. Admittedly, these are gut-wrenching considerations.
With all of this being said, go out into the world with caution.
Consider your local and regional positivity rate and number of deaths. The more deaths and the higher the infectivity rate – more caution is justified.
Consider investing in N-95 masks – these protect you from others as well as others from you. This is compared to the typical mask that protects others from you. Understand that the protection offered by N-95 masks is not absolute. Consider carrying hand sanitizer with you. Use it frequently. Be alert of your surroundings and the potential risks. Recognize potential high-risk areas – places where there are people conjugated together. Avoid these places to the extent possible. Avoid physical contact with others wherever possible. Attempt to maintain a minimum of six feet distance between yourself and anyone else.
Understand that the pandemic will likely be with us until there is an effective vaccine. As for a vaccine – we are getting closer. It will be here soon.