COVID-19 Update

The growth rate for deaths is holding pretty steady (1.002).

We can hope there are two basic things at work.

First, testing has widened enough now to catch a lot more of the milder cases.

(Which is what fuels President Stoopid's ridiculous contention that testing is actually causing us to have more cases - swear to phony god, if he'd just keep his tater trap shut and let the docs explain it, he wouldn't be in quite the mess he's in. But he doesn't know one fuckin' thing about one fuckin' thing, so he just goes on spouting bullshit)

Second, the medicos are getting a lot better at treating the patients. The problem now though is that they're running into the same problems in practically every city that they struggled with in NYC and Jersey - too many patients and not enough clinicians, PPE, beds or equipment.

WaPo:

The Health 202: The coronavirus death rate is likely to rise again as cases spike, experts say

President Trump has seized on a bit of positive news as coronavirus cases surge in new hot spots across the country: The country's deaths are still going down.

It's true that even as cases spike in western and southern states, deaths haven’t followed the same steep, upward curve — at least so far. Deaths are still on a downward trajectory; while as many as 3,000 people died daily from the illness in April, that figure has fallen to around 550 deaths per day.

“Deaths and the all important Mortality Rate goes down,” he pronounced in a pair of otherwise misleading tweets over the weekend:

But coronavirus deaths are almost certain to rise. The key question is how quickly.

“I do expect to see an increase in deaths in the coming weeks,” Lauren Ancel Meyers, a professor of biology at the University of Texas, told me. “Exactly how many more is uncertain, but unfortunately that is what we expect at this point.”

President Trump's former Food and Drug Administration chief Scott Gottlieb said on CBS’s “Face the Nation” that “the total number of deaths is going to start going up again as the number of hospitalizations starts to spike again.”

“You’re going to have more deaths, tragically," he said.

Epidemiologists say there are several potential reasons for why the death rate is trailing infections.
Infections appear to be spreading fastest among younger people as they start mingling more.

Younger Americans are far less prone to serious illness or death than elderly Americans, so it’s feasible that as the virus burns through this population, it may cause proportionally fewer hospitalizations and fatalities.

In Arizona, around 40 percent of known cases were among people younger than 44 at the beginning of May but that’s now up to 60 percent of all cases. Florida officials have said people ages 18 to 44 are primarily responsible for the state’s recent spike in cases. And in Texas, more than half of new cases in the counties that encompass Austin, Dallas, Houston and San Antonio are among the young.

And as testing becomes even more widespread — between 600,000 and 700,000 tests are now being conducted in the United States every day — more people with only mild cases of covid-19 or no symptoms at all are being included in the testing tallies.
Deaths also lag behind infections by three or four weeks.

Patients seriously ill with covid-19 generally don’t die until weeks into their illness. So, as infections and hospitalizations surge in states including Arizona, California, Texas and Florida, deaths will follow.

“We know death is a lagging indicator,” said Abraar Karan, a physician at Brigham and Women’s Hospital. “You have cases show up first, hospitalizations next and deaths show up after that.” 

It’s been clear for more than a month that infections are rising rapidly. Hospitalizations in most of these states are also climbing; over the weekend, coronavirus-related hospitalizations rose to their highest levels to date in Arizona and Nevada.

There are emerging signs that deaths are already trending upward in some states.

Compared to two weeks ago, the seven-day average of daily deaths is up nearly 50 percent in Florida and 54 percent in Arizona, according to the tracking website 91-DIVOC, which pulls data from Johns Hopkins University. The statewide death rate in both California and Texas is still holding steady, but some hospitals in both states have reported they’re nearing capacity in intensive care units.

“After Texas reported another single-day record for new coronavirus cases over the weekend, Austin Mayor Steve Adler (D) told CNN’s ‘State of the Union’ that there won’t be enough medical personnel to keep up with the spike in cases if the rate of increase continues unabated in his city,” Robert Barnes and Derek Hawkins report.

“If we don’t change this trajectory, then I am within two weeks of having our hospitals overrun,” Adler said, noting that the city's intensive care units could be overflowing within 10 days.
There's some good news: Doctors have figured out better ways of treating covid-19 patients.

Experts say this could be a small factor in lower death rates.

Physicians have come a long way in developing a standardized way of caring for covid-19 patients, compared to the pandemic’s outset. They’ve learned — and research has confirmed — that dexamethasone cuts the risk of death for patients on a ventilator by a third and reduces the risk of death for patients on oxygen by a fifth.

Another drug, remdesivir, has been shown to speed up hospital recoveries by four days, but didn’t have a statistically significant impact on survival rates. Doctors have also discovered that putting severely ill patients in a prone position improves the flow of oxygen to their lungs.

And here's the big one:

By the time deaths go up again, it could be too late to turn the trend around with more drastic restrictions.

New coronavirus infections in Florida, for instance, exceeded 10,000 in a day for the third time in the past week, after the state posted a record of 11,458 the previous day. “The new infections pushed the state’s total caseload past 200,000, a mark passed by just two other states, New York and California,” Robert and Derek write.

“Frustration about the pandemic response has mounted among local leaders, who say they have had to grapple with conflicting orders and frequently changing guidelines from governors and the White House as they try to curb sharply rising infections,” Derek and Marisa Iati report.

“We don’t have room to experiment; we don’t have room for incrementalism when we’re seeing these kinds of numbers,” said Judge Lina Hidalgo (D), the top elected official in Harris County, Tex., which encompasses the sprawling Houston metro area. “Nor should we wait for all the hospital beds to fill and all these people to die before we take drastic action.”