Bacon's Rebellion

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COVID-19: Doubling Every Three Days

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by

James A. Bacon
in

The latest numbers from the Virginia Department of Health, reflecting yesterday’s developments:

Cases: 890, up 151 from previous day.
Hospitalized: 112, up 13 from previous day.
Deaths: 22, up 5 from the previous days.
Tests: 10,609, up 1,443 from the previous day.

Here’s John Butcher’s cheerful little calculation, based on the latest data, of the “doubling time” for key Virginia metrics:

Case count: 3.14 days
Hospitalizations: 3.68 days
Deaths: 2.56 days

And then there’s this: The Institute for Health Metrics and Evaluation has forecast when the virus will start overwhelming hospital capacity in the 50 states. The Institute forecasts that Virginia will encounter “peak resource use” on May 2, 2020. At that point, 3,435 hospital beds will be needed. Virginia has more than enough beds, so there will be an acute-care “bed shortage” of zero. The problem is that Virginia will need 512 ICU beds. Only 329 will be available, creating a shortage of 183 ICU beds. Also, Virginia will have a shortage of 276 ventilators.

Deaths from the virus will peak around 30 daily. Total deaths: 1,543.

(Hat tip: Jim Loving.)

The projection assumes that social distancing measures are maintained over the next four months. Frankly, that’s not as bad as I would have expected. I wonder if the CDC will calculate the increase in alcoholism and drug overdoses, suicides, and domestic abuse murders resulting from job losses and social isolation so we can determine whether the crackdown saved lives or simply displaced lost lives from one category to another.

If these numbers are anywhere close to realistic, Virginia’s health care providers should be focusing on alleviating the shortage of ICU beds, not the overall number of hospital beds.

By the Institute’s reckoning, the shortage of acute-care and ICU beds will be far more desperate in the New York/New Jersey. Connecticut region than in Virginia. Our contagion-combating measures should not be dictated by headlines and TV broadcasts coming out of the New York area.

— JAB

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7 responses to “COVID-19: Doubling Every Three Days”

  1. LarrytheG Avatar
    LarrytheG

    yeah, I’m surprised … I thought we had a much steeper hill to climb and if we do more testing, other positive things might happen.

  2. Reed Fawell 3rd Avatar
    Reed Fawell 3rd

    A cautionary tale, quoting Christopher Balding:

    “… Let us start with how rapidly corona spreads. As we can show with simple match, assuming all corona cases are observed confirmed cases, corona grew at a daily rate of 10.5%. However, according to widely cited public sources, the daily growth rate in many countries is well above this.

    Arguably the most repeated phrase in corona publicity is that it is growing at 30% daily. At the outset, we can discard this number as entirely unrealistic. How do we know? If that number were true of the virus from when it became known on November 15, it would have already infected 1.4 quadrillion people. However, this number must also be false even if we just focus on the United States. Again, how do we know? Assume the virus entered the US, roughly accurate assumption based upon existing evidence, on January 1, 2020 and grew at 30% daily, it would have already infected 6.3 billion Americans. In other words, it would have infected every American man, woman, and child 19 times. However, neither can it be the globally observed number of 10.5%. If it entered America on January 1, this would result in fewer than 6,000 corona cases. So the question becomes: how fast is corona spreading?

    Before we look at what research from lots of countries is producing, let us point out, many theoretical studies are using the official World Health Organization number. This number typically sits in various modeling papers of an R0 between 2.0-2.5. I will save the notes about how poorly the WHO has handled things for another time but note here that papers like the Ferguson paper rely on these numbers. The Ferguson paper utilize R0 ranging from 2.0-2.6. A lower R0 says that the disease is spreading slower than a high R0 and would be more consistent with observed confirmed cases equaling the total number of real cases. A higher R0 means corona is spreading faster and implies higher numbers of unobserved cases. Given the WHO use of these numbers, many researchers can be forgiven for relying on them. However, are the official WHO R0 accurate? …

    For much more see:
    https://www.baldingsworld.com/2020/03/29/how-fast-is-corona-spreading-and-how-many-undetected-cases-are-there/

  3. Nancy_Naive Avatar
    Nancy_Naive

    This COVID-19 stuff has to go, and the season get back to normal. There I am just about to pull a $1000 out of my bookie’s hide on a 10:1 bet when Pete Rose, of all people, hits a 2-run homer. Geez, how old is that guy?

  4. cjbova Avatar
    cjbova

    Thanks, Reed. Christopher Balding makes a lot of sense. We know that the VDH testing criteria has changed again and age is no longer a factor. Those with mild symptoms are not being tested unless they’re a healthcare worker or first responder, or part of a potential cluster outbreak, or reside or work in a congregate setting.

    It seems even hospitalization isn’t a criteria, and only done there as a confirmation to provide “compassionate use treatment with antivirals.”
    http://www.vdh.virginia.gov/coronavirus/health-professionals/vdh-updated-guidance-on-testing-for-covid-19/

    So if those with mild symptoms and those who are asymptomatic are not being tested, and they have been spreading the virus further than we recognize, that could mean the percentage of those becoming seriously ill is much smaller than it appears now. If that is the case, then it may be that those numbers won’t involve a catastrophic level of need for ventilators and ICU beds.

    Maybe the key factors will be end up being ones we can’t know yet–how long each ICU patient will need ventilator support, and did the IHM have enough valid statistics on which to base their estimates?

  5. Nancy_Naive Avatar
    Nancy_Naive

    “100,000 dead would be a very good job.” — Trump

    Don’t worry, Mr. President, you’ll do better than that.

  6. cjbova Avatar
    cjbova

    Two corrections on my previous post:
    I overlooked posting a key factor in the testing guidelines: health care workers or first responders have to have a fever or other lower respiratory illness symptoms and the same for those working or living in congregate settings.

    They will test persons “Person hospitalized with fever OR signs of lower respiratory illness. Priority will be given to patients where circumstances require a confirmed COVID-19 diagnosis for compassionate use treatment with antivirals.”

  7. LarrytheG Avatar
    LarrytheG

    Carol – do you think some of this is caused by a shortage of tests or is it that there are plenty of tests but wrong protocols ?

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