At least 12,000 Americans have already died from COVID-19 this month, as the country inches through its latest surge in cases. But another worrying statistic is often cited to depict the dangers of this moment: The number of patients hospitalized with COVID-19 in the United States right now is as high as it has been since the beginning of February. It’s even worse in certain places: Some states, including Arkansas and Oregon, recently saw their COVID hospitalizations rise to higher levels than at any prior stage of the pandemic. But how much do those latter figures really tell us?
From the start, COVID hospitalizations have served as a vital metric for tracking the risks posed by the disease. Last winter, this magazine described it as “the most reliable pandemic number,” while Vox quoted the cardiologist Eric Topol as saying that it’s “the best indicator of where we are.” On the one hand, death counts offer finality, but they’re a lagging signal and don’t account for people who suffered from significant illness but survived. Case counts, on the other hand, depend on which and how many people happen to get tested. Presumably, hospitalization numbers provide a more stable and reliable gauge of the pandemic’s true toll, in terms of severe disease. But a new, nationwide study of hospitalization records, released as a preprint today (and not yet formally peer reviewed), suggests that the meaning of this gauge can easily be misinterpreted—and that it has been shifting over time.
If you want to make sense of the number of COVID hospitalizations at any given time, you need to know how sick each patient actually is. Until now, that’s been almost impossible to suss out. The federal government requires hospitals to report every patient who tests positive for COVID, yet the overall tallies of COVID hospitalizations, made available on various state and federal dashboards and widely reported on by the media, do not differentiate based on severity of illness. Some patients need extensive medical intervention, such as getting intubated. Others require supplemental oxygen or administration of the steroid dexamethasone. But there are many COVID patients in the hospital with fairly mild symptoms, too, who have been admitted for further observation on account of their comorbidities, or because they reported feeling short of breath. Another portion of the patients in this tally are in the hospital for something unrelated to COVID, and discovered that they were infected only because they were tested upon admission. How many patients fall into each category has been a topic of much speculation. In August, researchers from Harvard Medical School, Tufts Medical Center, and the Veterans Affairs Healthcare System decided to find out.
Related: Catholic schools will sue Dane County Madison Public Health to open as scheduled
Notes and commentary from Scott Girard:
“While Heinrich allowed schools to use their premises for child care and youth recreational activities, the government barred students from attending Mass, receiving Holy Communion at weekly Masses with their classmates and teachers, receiving the sacrament of Confession at school, participating in communal prayer with their peers, and going on retreats and service missions throughout the area.”
“Reasonable” should mean that the public health authorities followed their own internal guidelines for evaluating regulations. These include posting the scientific evidence leading to the regulation, receiving community input, and studying the effectiveness and sustainability of the regulation. In the case of Covid and the schools all this was ignored in Dane County. There was no evidence of transmission in children of school age at the start, the community’s wish to have the schools open was ignored and, over time, it was seen that surrounding counties kept their schools open without increasing Covid transmission – and this last point was completely ignored by Dane County. But the Supreme Court didn’t address the issue of irresponsible public health officials. Perhaps it cannot as Owen pointed out. Perhaps dereliction of duty must be addressed by criminal courts. Instead the Supreme Court answered a different question which might be put as follows: suppose a majority of children in a given community refused the regular vaccines – or refuse the covid vaccine – can the public health authorities close the school? The answer was no. This is significant because racism has been defined as a public health issue. Suppose a majority of parents refused to allow their children to attend a CRT seminar defined as immunization against racism and required for admittance to school. Could the public health authorities close that school. No. In the past certain religious tests have been required before attendance at universities was allowed and non-conforming universites have been closed. If racism is a public health issue the Test Acts may return as public health tests and if that happened we may be sure Dane County would adopt Test Regulations closing non-conforming public schools if it could. Then this Court decision, barring such Test Regulations, would seem far-sighted.
Notes and links on Dane County Madison Public Health. (> 140 employees).
Molly Beck and Madeline Heim:
which pushed Dane County this week not to calculate its percentage of positive tests — a data point the public uses to determine how intense infection is in an area.
While positive test results are being processed and their number reported quickly, negative test results are taking days in some cases to be analyzed before they are reported to the state.
The department said it was between eight and 10 days behind in updating that metric on the dashboard, and as a result it appeared to show a higher positive percentage of tests and a lower number of total tests per day.
The department said this delay is due to the fact data analysts must input each of the hundreds of tests per day manually, and in order to continue accurate and timely contact tracing efforts, they prioritized inputting positive tests.
“Positive tests are always immediately verified and processed, and delays in processing negative tests in our data system does not affect notification of test results,” the department said in a news release. “The only effect this backlog has had is on our percent positivity rate and daily test counts.”
Staff have not verified the approximately 17,000 tests, which includes steps such as matching test results to patients to avoid duplicating numbers and verifying the person who was tested resides in Dane County.
All 77 false-positive COVID-19 tests come back negative upon reruns.
Madison private school raises $70,000 for lawsuit against public health order. – WKOW-TV. Commentary.
WEAC: $1.57 million for Four Wisconsin Senators
Assembly against private school forced closure.
Wisconsin Catholic schools will challenge local COVID-19 closing order. More.
2017: West High Reading Interventionist Teacher’s Remarks to the School Board on Madison’s Disastrous Reading Results
Madison’s taxpayer supported K-12 school district, despite spending far more than most, has long tolerated disastrous reading results.
My Question to Wisconsin Governor Tony Evers on Teacher Mulligans and our Disastrous Reading Results
“An emphasis on adult employment”
Wisconsin Public Policy Forum Madison School District Report[PDF]
Booked, but can’t read (Madison): functional literacy, National citizenship and the new face of Dred Scott in the age of mass incarceration.