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Medicine Stats

Incomplete Data May Mask an Increase in US Covid Cases, But Infection Counts De-Emphasized (nbcnews.com) 140

"At first glance, U.S. Covid cases appear to have plateaued over the last two weeks," reports NBC News, "with a consistent average of around 30,000 per day..."

"But disease experts say incomplete data likely masks an upward trend." "I do think we are in the middle of a surge, the magnitude of which I can't tell you," Zeke Emanuel, vice provost of global initiatives at the University of Pennsylvania, said. The BA.2 omicron subvariant, which now accounts for about 72 percent of U.S. cases and is more contagious than the original omicron variant, is fueling that spread, Emanuel added. "It's much more transmissible. It's around. We just don't have a lot of case counts," he said.

Emanuel and other experts cite a lack of testing as the primary reason cases are underreported. At the height of the omicron wave in January, the U.S. was administering more than 2 million tests per day. That had dropped to an average of about 530,000 as of Monday, the most recent data from the Centers for Disease Control and Prevention. "The milder symptoms become, the less likely people are to test or show up in official case counts," said David Dowdy, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health. More people also now have access to at-home rapid tests that are free or covered by insurance, and most of those test results don't get reported to state health departments or the CDC.

"Case counts and testing are progressively becoming shaky indicators because we're not catching everyone in the system," said Dr. Jonathan Quick, an adjunct professor at the Duke Global Health Institute.

Some local data, however, does reveal recent spikes. Average Covid cases have risen nearly 80 percent in Nebraska, 75 percent in Arizona, 58 percent in New York and 55 percent in Massachusetts over the last two weeks. Wastewater surveillance similarly suggests that infections are rising in Colorado, Ohio and Washington, among other states.

The Johns Hopkins epidemiologist emphasized that hospitalization figures are more important than case counts.

"If we're seeing an increase in cases, but not an increase in severe cases, I think it's a very valid question of does that matter?"
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Incomplete Data May Mask an Increase in US Covid Cases, But Infection Counts De-Emphasized

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  • by JoshuaZ ( 1134087 ) on Sunday April 10, 2022 @12:44PM (#62434264) Homepage

    "If we're seeing an increase in cases, but not an increase in severe cases, I think it's a very valid question of does that matter?"

    Yes for four reasons. First, the risk of long-covid is a thing and it seems to occur even in many people who were not hospitalized. Second, hospitalizations trail case totals, so an increase in case totals will likely lead to an increase in hospitalization later. Third, people who are high risk such as immunocompromised people may need to take more precautions if case totals are higher. Fourth, higher case totals are also bad because they give the virus more opportunities to mutate.

    • by Junta ( 36770 ) on Sunday April 10, 2022 @01:00PM (#62434298)

      The question of 'does it matter?' depends on the audience. Healthcare professionals, sure, they have to keep an eye on this, and every other infectious disease, particularly watching for signs of decline in effectiveness of vaccine.

      The average random person walking around? Practically speaking they should be able to go to largely ignoring it and waiting for the professionals to indicate a time to take action. At this point they've done about all they can reasonably do and there's no foreseeable improvement coming to stall for. We have vaccines, we have treatment protocols, the health system has a very light covid load. Despite a fairly prolonged period of most people no longer acting with caution, cases of significant severity have continued to decline. This is a trailing indicator sure, but even wastewater testing (where everyone is being indirectly tested, healthy and sick alike) is showing less than half a percent of the amounts seen three months ago.

      • I think what concerns me is that there is a dismantling of reporting. My state switched to weekly reporting, which is pretty useless for giving any warning. I don't think their sewage treatment reporting is fully deployed either, and to the extent it is, it only covers 1/3 the population at most.

        It makes perfect sense to de-emphasize the case counts at this point, but not having an accurate count (or proxy) is just stupid because these tools are needed for preemptive reasons.

      • Re: (Score:1, Funny)

        "... particularly watching for signs of decline in effectiveness of vaccine"

        Bad grammar is indicative of addleness.

      • by AmiMoJo ( 196126 ) on Monday April 11, 2022 @03:59AM (#62435418) Homepage Journal

        Aside from Long COVID being a horrible, debilitating disease that people should avoid at (IMHO) any cost, the government needs to consider the economic down-side to having millions of people unable to work or at reduced productivity levels.

        In the UK we have between 1 and 1.5 million people with Long COVID. The effect of having a million people living on disability/long term sickness benefits is going to be extremely bad for the economy and the government's finances.

        • by Junta ( 36770 )

          This has to be weighed against expectations of having any *new* solutions to the problem and opportunity costs of continued restrictions.

          We don't have any reason to expect a new improvement in tools at our disposal. We have vaccines, treatments, and we know we can't manage to eradicate it entirely and it is doomed to be endemic. People have had ample opportunity to avail themselves of the vaccines and we've pretty much exhausted ways to get them to do this.

          Further, long covid is predominantly a consequence

        • I would assume that you would have to get really sick to have 'long covid'. If the newer strains aren't making people sick enough to seek medical help, they aren't getting long covid.
    • Re: (Score:1, Interesting)

      by Anonymous Coward

      Yes for four reasons. First, the risk of long-covid is a thing and it seems to occur even in many people who were not hospitalized.

      This doesn't mean anything to me. If I get covid today, next week, month or few months my risk of "long-covid" is not meaningfully different. Current vaccines do not stop infection and it is both a fools errand and counterproductive to attempt to hide from this virus the rest of ones life. Whatever change to my short term personal risk of infection with time is not important to me. The issue is not worth my time.

      Second, hospitalizations trail case totals, so an increase in case totals will likely lead to an increase in hospitalization later.

      What is relevant is the fact no reasonable danger to hospital systems exist given there are

      • Re: (Score:2, Informative)

        by Anonymous Coward

        Yes for four reasons. First, the risk of long-covid is a thing and it seems to occur even in many people who were not hospitalized.

        This doesn't mean anything to me. If I get covid today, next week, month or few months my risk of "long-covid" is not meaningfully different

        If you get COVID today you may also get it in a few months. You run a risk of long COVID each time, unfortunately. To what extent that risk changes each time is not very clear, though, nor the long term effects of long COVID.

        • by XXongo ( 3986865 )

          Yes for four reasons. First, the risk of long-covid is a thing and it seems to occur even in many people who were not hospitalized.

          Not yet known.

          Whether the long COVID aftereffects crop up in people who had mild cases (including those whose cases were mild because of immunization) is as-yet not established.

          • Yes, from personal experience, long covid happens even in mild cases. In fact, it can be worse than the original symptoms.
      • . If I get covid today, next week, month or few months my risk of "long-covid" is not meaningfully different.

        You can get multiple infections. Each time you do, you have another chance to do so. And the longer you wait, the more time we have to develop other treatments, better anti-virals, etc.

        What is relevant is the fact no reasonable danger to hospital systems exist given there are few people left in the US who are naive to sars2 virus thru infection and or vaccination.

        This really isn't accurate. At this point we have strong evidence that reinfection is a frequent thing in the unvaccinated, and that Omicron in particular gives little protection to unvaccinated against subsequent infections. See for example https://www.cell.com/cell-host-microbe/fulltext/S1931-3128(22)00159-7 [cell.com].

        This is why such people receive extra doses.

        That isn't the

        • by jbengt ( 874751 )

          . . . small pox did mutate but had a roughly slow mutation rate, so we were able to wipe it out completely.

          The reason we were able to wipe smallpox out completely is that it didn't have any animal hosts, so vaccinating humans was sufficient. That is not the case for most viruses.

        • You can get multiple infections. Each time you do, you have another chance to do so.
          And the longer you wait, the more time we have to develop other treatments, better anti-virals, etc.

          The longer you wait will always be true of everything even 100 years from now. Meanwhile I can get shot, fall off a ladder, hit by a truck, struck by lightning or die of any of a zillion causes. Life itself is neither safe nor guaranteed. Risk and cost of risk mitigation must be weighed according to real world merit rather than ideological abstractions.

          Given present transmissibility of sars2 virus waiting with any chance of success means being a hermit forever. In my view this is not a rational precau

    • We let'er rip so badly with Omnicron that the sort of person likely to get a severe case is already dead.

      No joke, a CNN article I can't find at the moment called it "failing up". That's not really a valid use of the term though, since those people are still dead.

      Or dying. Just saw a HermainCainAward nominee on month 8 of his hospital stay. His (anti-vax) family were freaking out because the insurance company was cutting them off (shouldn't be possible with the ACA but the Republicans snuck several h
      • HermainCainAward nominee on month 8 of his hospital stay. His (anti-vax) family were freaking out because the insurance company was cutting them off

        Good grief, Herman Cain died before any covid vaccine was even available.

        • Herman Caine got covid because he refused to wear a mask, and then he went to a Trump rally, and stood in a crowd of people who also refused to wear masks.
          Herman Caine had suffered from serious cancer a few years before and was also 74.

          We call that "getting your just desserts" and that is the reason for the Herman Caine awards.

          • Re: (Score:2, Troll)

            Herman Caine got covid because he refused to wear a mask

            You don't know that.

            and then he went to a Trump rally, and stood in a crowd of people who also refused to wear masks.

            What has this to do with anti-vaxxers? Do you have any objective evidence for believing Herman Caine would have objected to vaccination when it became available to him?

            Herman Caine had suffered from serious cancer a few years before and was also 74. We call that "getting your just desserts" and that is the reason for the Herman Caine awards.

            I just don't understand the connection. If you are going to mock the dead and condone illogical anecdotes there are no shortage of some left and many right wing nutjobs (no offense to rightwingnutjob) who elected not to get vaccinated and later died from covid to pick from.

            Why use someone who didn't even do the thing the

          • I'm curious: what award are we giving out to those who wore masks, got vaccinated, and still died from covid?
            • by nagora ( 177841 )

              I'm curious: what award are we giving out to those who wore masks, got vaccinated, and still died from covid?

              The same one we give to careful drivers who are killed when someone else drives into them - the Bad Luck award.

          • Hot take: cloth masks wouldn't have saved him. Paper masks probably wouldn't have either. Properly-fitted N95s that stayed perfectly dry and unperturbed on shaven faces (no facial hair!) might have worked.

            • by jbengt ( 874751 ) on Monday April 11, 2022 @09:32AM (#62435860)
              The data I: read recently was that cloth masks vary greatly in efficacy, some are close to 0% effective, but they average maybe 20%. Surgical masks are 40% to 60% effective, if they are reasonably well fit, and N95 masks are very effective if they are well fit, including, like you say, no facial hair.
    • Look at what's currently happening in China what chasing zero infections costs for Omicron.

      It's simply unsustainable in western nations. We're all Sweden now. She'll be right ... or not. Regardless, this is how it is.

    • So let's say we have great/perfect indicators of cases rising. What, exactly, do you want to do about it? Stay at home? Shut down businesses? Avoid each other? Keep wearing barely functional masks? Even your third point about immunocmpromised people doesn't make sense. Are they really going out and about with no precautions when there are X number of cases a week, but then will suddenly take more precautions when it reaches Y number of cases a week?

      COVID is not going to go away. We've done all we c

      • So let's say we have great/perfect indicators of cases rising. What, exactly, do you want to do about it? Stay at home? Shut down businesses? Avoid each other? Keep wearing barely functional masks?

        Some steps are easy to take. Indoor dining at restaurants for example is a major cause of covid spread. Given that weather is better in many parts of the US, requiring out door seating or drastically reducing in door seating are both easy steps. It is true that most masks people are using only do very little. But the easy answer there is to get better masks, N-95s an KN-95s especially. We also can do more systematic testing. Many universities have just stopped their testing, but systematic regular testing

  • In my area.. (Score:4, Informative)

    by Junta ( 36770 ) on Sunday April 10, 2022 @12:46PM (#62434270)

    The wastewater tests show an uptick, but every other metric is down. So sure, BA.2 has been rising but hospital admissions have been on the decline, test results are still showing a decline, but the fact that people aren't bothered enough to get those tests speaks to it.

    It's worth keeping an eye on it, but it doesn't make a whole ton of sense for us to try to find reasons to find data to panic over when all the indicators of consequence are still looking healthy.

    Main thing of interest for the prevalence of the disease is to keep an eye on vaccination and plan what might be needed to maintain the current state of affairs, but nothing needing the continuous attention of the average person at this point.

    • by jbengt ( 874751 )

      It's worth keeping an eye on it, but it doesn't make a whole ton of sense for us to try to find reasons to find data to panic over when all the indicators of consequence are still looking healthy.

      The test positivity rate is going up. That is one indicator that is trending poorly. It remains to be seen if that is a problem going forward with a population that has mostly already been infected or vaccinated.

      • by Junta ( 36770 )

        Basically, I look toward wastewater testing for the 'heads up' due to the indiscriminate nature of the testing, and hospitilizations for how severe it is.

        Of the metrics, number of detected cases and particularly test positivity rate I view as not that reliable, as it depends upon whether people feel like being tested. Test positivity rate going up may mean more people are getting it, or it could mean thot fewer asymptomaticapeople are bothering to get tested and/or that non-covid respitory illnesses are wa

  • by quonset ( 4839537 ) on Sunday April 10, 2022 @01:21PM (#62434326)

    Emanuel and other experts cite a lack of testing as the primary reason cases are underreported.

    “If we stop testing right now, we’d have very few cases, if any,”

    Thus spoke the con artist in June of 2020. Stop testing and covid goes away. It's completely logical. You can't have cases if you don't test.

    • “If we stop testing right now, we’d have very few cases, if any,”

      Thus spoke the con artist in June of 2020. Stop testing and covid goes away. It's completely logical. You can't have cases if you don't test.

      Sadly (or hilariously), that's probably not the dumbest thing he's said (or done, said the solar eclipse), even just in office. (And people still voted, and want to vote, for him again.)

    • miss the point somebody it making.

      The Bad Orange Man is often inelegant in speaking, and like the majority of CEOs, poor at accurately relaying what he' heard smarter people tell him, but he was in this instance making a point which was easy to get if you were paying attention to the debate at the time and not working overtime to intentionally spin everything he uttered into the worst light possible.

      The point was (and still IS) that it's INSANE to try to waste [at that time rare] resources to test everybod

      • by quonset ( 4839537 ) on Sunday April 10, 2022 @06:45PM (#62434874)

        The point was (and still IS) that it's INSANE to try to waste [at that time rare] resources to test everybody in an entire population for a disease that 98% will survive, and then go nuts over the "infection rate", when what matters in such an illness is the HOSPITALIZATION and DEATH rates.

        So what you're saying is when there is a highly transmissible viral infection rampaging through the population you don't want to know about it. Got it.

        As to the hospitalization rate, we knew the rate because hospitals across the country were overwhelmed for nearly two years. At some point hospitals put off all non-emergency surgeries, and in some case even emergency surgeries beause they had no more room. People were dying because they couldn't receive the surgery [cnn.com] or care they needed because covidiots were occupying all the beds.

        And for the, "But it only kills 1%", it's not just the deaths [democratic...ground.com]. It's the people who are out of commission for weeks or months recovering, those who will need organ replacements or have organ damage in general, those who will have permanent congnitive dysfunction for the rest of their lives, and those who will never be able to work again.

        We have never before done this, not even with HIV (which was 100% fatal to anybody infected in the mid-1980s)

        Let us know when HIV can be transmitted through the air.

        if you reduce the insane testing levels, you reduce the number of people who you can panic over as "infected" but who are walking around with few or no symptoms and who will never get sick enough to need any care.

        Panic? What panic? The only ones talking about "panic" are you and Republicans. I never panicked. No one I knew around me panicked. No one I worked with panicked. In fact, in my entire metropolitan area not one person I ever came in contact with "panicked". It's a buzzword in the same manner Putin having nukes. It's a throwaway designed to mislead people into something which doesnt exist.

        The fact you and many Republicans whined about "the economy" while a virus was killing tens of thousands of people each week shows their "pro-life" stance is a farce. If people are dying, getting hospitalized or even staying home for extended periods, the economy is tanking anyway. And then what do you have to blame?

  • So Excess Deaths (Score:5, Interesting)

    by rsilvergun ( 571051 ) on Sunday April 10, 2022 @01:31PM (#62434354)
    appear to be about 3 times higher [nbcnews.com] than reported deaths. 1/3 of that seems to be US alone.

    It's safe to say we're under reporting COVID deaths. In particular we've got folks getting it, surviving, and succumbing to heart attacks and strokes shortly after due to lingering effects. Funny thing about losing lung capacity to COVID and taking damage to your heart muscles, it doesn't help when you get a heart attack...

    Oh, and yes, the bulk of these deaths are concentrated in "red states", largely due to lower vaccination numbers because we politicized vaccination for a cheap political victory.
  • by belg4mit ( 152620 ) on Sunday April 10, 2022 @02:33PM (#62434472) Homepage

    It won't cover everywhere, especially rural areas, but surely sewage data tracking is still available e.g; https://www.mwra.com/biobot/biobotdata.htm [mwra.com]

  • ...in an election year? I mean, you'd have to be a complete sociopath to, say, prioritize the re-election of your candidate over human lives, wouldn't you?

    I seem to recall a number of people making the same sort of comment about a previous president that didn't take COVID as seriously as they felt he should.

  • "If we're seeing an increase in cases, but not an increase in severe cases, I think it's a very valid question of does that matter?"

    Given what we've seen of the long-term effects of non-severe infections (ones that don't hospitalize the patient), it may matter quite a bit. A lifetime of respiratory and circulatory and neurological problems isn't exactly something you can ignore. Gambling is bad enough, but here you're gambling with a stack of chips that you know you're going to have to pay for but you don't

  • I am so scared of all new possible versions of Covid-19. I have gotten bored of wearing masks, but my fear of getting infected is more significant. I am a student, and till recently, we were studying online. I regret and don't like that we began an offline regime; since a report from https://writix.co.uk/report-writing-service [writix.co.uk] shows that health security is higher in school districts where students and pupils are learning via digital platforms. At least, I feel better when studying on moodle and getting educ

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