The health "experts" and the media propagating viral panic porn think people like us don't understand arithmetic. They think they can manipulate headline stories warning of increased cases of COVID-19 in order to push more lockdowns, ignoring all the ways that more cases are being discovered, while the percentage of positive tests, new hospitalizations and deaths, and the lethality of the virus are all waning significantly.
"Arizona's COVID-19 spread is 'alarming' and action is needed, experts warn," read the title of an Arizona Republic article on Wednesday. Yahoo News breathlessly warned about a "spike" in all the southwestern states.
As is always the case, there is a grain of truth that is hugely distorted by numerous obfuscations of important facts and context. The truth is that new hospitalizations of people coming in for serious coronavirus infections are actually extremely low. What they are actually counting are the extra people coming in for all of the delayed health care caused by the lockdown. But thanks to universal testing in hospitals, they are discovering more asymptomatic cases than ever before, which had nothing to do with the original purpose of the hospital stay. Thus, they are blaming the fallout of the lockdown on the easing of the lockdown!
This chart from Arizona's coronavirus dashboard says it all.
Check out what happens in Arizona when you do a 7d rolling aver of hospitalization to case rate (using a 7-day lag)… https://t.co/EZC6HGPCvY— Kyle Lamb (@Kyle Lamb) 1591749923.0
As you can see, if you break down the new admissions by date of admission, as this chart does, the numbers are actually near zero over the past week. There was only one new admission on Wednesday, the last day of reporting. What the media is focusing on is the cumulative total of beds in use, reflected in this chart.
The total number of "positive" COVID-19 patients currently using beds in the hospital system is high. Now you might wonder how cumulative numbers could be so high if the new daily intake is so low? It's quite obvious that the first chart is only counting those who actually come in with new serious cases of COVID-19, for example those who have trouble breathing because the virus attacked their lungs. Those cases are extremely low relative to April.
The cumulative number chart, on the other hand, counts any "positive or suspected inpatient COVID-19 patients." Now that the number of people coming into hospitals in general, for any reason, is much higher than during the peak of the epidemic and also testing has become standard, they are likely counting anyone who tests positive as a COVID-19 patient in that chart, even if they came in for chest pains or trauma. Which is why there is a note at the bottom of the chart observing that the numbers are very volatile. Obviously, if the same number of patients of all conditions had come in to hospitals six weeks ago and we had had the rapid testing capabilities, the number of positive cases would have been recorded as even higher than they are today.
This dichotomy is likely reflected in the following chart of COVID-positive patients admitted to the emergency rooms.
How can it be that the same government website showing literally no more than five new COVID-19 admissions a day this week also shows record emergency room COVID-positive patients? The answer is that the virus is much more widespread, asymptomatic, and less deadly than it was before. The ER patients are coming in, as the Arizona state health director, Dr. Cara Christ, said, because of the bottleneck of much-needed care and serious ailments that were ignored during the lockdown. All but the few who actually came to the ER because of COVID-19 symptoms likely never knew they had it. This is why we are not seeing a big spike of deaths in any of the states where the media is warning about an increase in detected cases.
The very states that are seeing increases in hospitalizations are the ones that barely had patients – COVID-19 or otherwise – for six weeks because the virus didn't hit hard but the panic and suspension of certain procedures caused the admissions to plummet (unlike in New York, for example, where there were enough COVID-19 patients to fill hospitals). Now that the lockdown is over, states like Texas, Arizona, California, and North Carolina have many more people coming in to hospitals than in April. Paradoxically, it makes sense that there will be more people testing positive now than even during the peak, especially because testing is universal and rapid.
It's hard to measure a curve when we didn't have the full data during its peak. Had we been testing every person in March and April, there likely would have been many more cases.
Hence, the dichotomy between those "hospitalized with COVID-19" and those hospitalized because of COVID-19 is very similar to the inflation of the death toll we've seen, where the number of those who die with COVID-19 but not because of it get conflated with those who die of the virus itself.
The same trend we see in Arizona is playing out in Texas and likely in other states that had both low COVID-19 numbers and very few general patients in hospitals during the peak of the epidemic.
Thus, the dichotomy between patients who are actually being driven to the hospital by the virus vs. those who are there for other purposes and just test positive is huge and did not exist during the peak.
It's not that the virus doesn't exist any more, it's that it has either become less potent, has already attacked those who would otherwise get seriously ill from it, or a mixture of both. This is why Dr. Donald Yealy, the chair of emergency medicine at UPMC, who's been responsible for 30,000 tests in Pennsylvania, recently observed that those with the virus appear to be carrying lower viral loads and aren't getting as sick from it as they did in March and April.
This is why in Wisconsin, where thanks to the state supreme court ruling, citizens have been free from lockdown for nearly a month, not a single COVID-19 death was reported on Tuesday. Even though the number of positive cases has not gone down that much, deaths have plummeted.
Likewise, among the states the media is flagging for a spike in cases is California, which had a long and strict lockdown. Of course, there is zero correlation in outcomes. Overall, even that "spike" was reversed yesterday:
Below is a raw graph straight from our hospital census data column (TCTP) We had an influx in CA AZ FL and TX - co… https://t.co/ZOBD6OE22I— Ethical Skeptic ☀ (@Ethical Skeptic ☀) 1591913974.0
One other factor driving the discovery of more cases is the now widespread serology tests that discover antibodies in many people who never knew they had the virus. Those are also counted in the case numbers and hospitalization numbers in some states.
As I was saying a few days ago, cases aren't really spiking (serology positives are responsible for the excessive c… https://t.co/TnQ9KJLpN5— Kyle Lamb (@Kyle Lamb) 1591894848.0
Finally, it's important to note that a large factor driving recent hospitalizations and likely several of the more deadly cases in southwestern states in particular could be due to cases in Mexico. The New York Times ran a story earlier this week on hospitals in California being flooded with people coming from Mexico who are seeking better care.
It's hard to compare state data when some states are getting backwash from other countries' cases. As Brownsville public health director Arturo Rodriguez said, "In other words, you have three rates: the U.S., Mexico and your border rate."
Already, two weeks ago, the Washington Post reported the following: "As Mexico's health-care system has strained under the coronavirus, small community hospitals in Southern California, some of the poorest in the state, have been flooded with Americans who have fallen ill and crossed the border. They are retirees and dual citizens, Americans working in Mexico or visiting family there."
According to the Post, "approximately half of the coronavirus patients in several California border hospitals, including El Centro Regional Medical Center, are recent arrivals from Mexico." Which is why Imperial County has more cases per capita than any other county in the state.
This explains why some of the largest spikes in cases and even some new deaths have been in border counties, such as Texas' Rio Grande Valley. Thus, if increased cases are used as a pretext for continuing to lock down American citizens, there is no reason why the border shouldn't be closed to medical tourism, at least from non-citizen green card holders, given that the main purpose was to alleviate the strain on our hospitals.
The media, as always, are engaging in headline panic news and fudging math that proves the exact opposite of their headlines. It's similar to what they are doing with accusations of executive force, in light of George Floyd's death, against black criminals while ignoring the fact that black criminals commit an even greater share of violent crime, which proves shooting of white criminals is even more common per capita. They think we don't understand arithmetic.
And speaking of Minneapolis, if small-scale reopening in these other states led to a spike in the virus, then don't you think jam-packed protests beginning over two weeks ago in Minneapolis would have caused a spike, rather than a drop, in hospitalizations?