Tag Archives: sars2
CV19 US Hospitalization Rates
CV19 Pandemic Update!
US has stepped up testing rapidly, and so while social distancing is at -40%, we still show +1% of the new model prediction.
03-26 Thursday
1-day Projection: WW 524523/24175; PRC 81731/3289; NON 442792/20886; IT 79988/8254; US 80513/1257; TX 1582/19 non+IT 1.2%, US 5.1%
1-Day Distancing: WW 524523/24175; PRC 81731/3289; NON 442792/20886; IT 79988/8254; US 82170/1244; TX 1632/20 TX 5% high, US 2% low
Actual Numbers: WW 529591/23970; PRC 81782/3291; NON 447809/20679; IT 80589/8215; US 83836/1209; TX 1563/21
The rapid rise in US testing (127% per day average) may numerically counter the decrease in disease spread from social distancing (-40%). I hope that is factored into the policy plans, because it may look a lot more spooky over the next week than it really is.
03-27 Friday
1-Day Projection: WW 601509/27192; PRC 81903/3297; NON 519605/23895; IT 87309/8995; US 106851/1552; TX 1988/29
1-Day Distancing: WW 601509/27192; PRC 81903/3297; NON 519605/23895; IT 87309/8995; US 103554/1554; TX 1971/27
1=Day US Prototype: Positive: 89,618 Negative: 486,863 Pending: 66,880 Hospitalized: 13,923 Dead: 1,471
I added the Number of Tests and number hospitalized in the US to the spreadsheet. This is somewhat complete for the US and TX, but other countries are hit or miss. Those checkpoint earlier in the day than other stats, but that is fine. Those are much better numbers to track hospital overload than trying to extrapolate from confirmed cases, but much less data. I am still tweaking it all.
Midday Thursday, the US had 10131 hospitalized, and 1163 dead from COVID-19. The rates of increase of these are still climbing at the typical 135% per day. There is not yet a clear correlation between social distancing and death or hospitalization rates, but I am still testing ideas.
Since I only have that for the whole US, I am still tracking confirmed, death, and projecting with social distancing in the main sheet.
2020-04-01 7-day Comparison
7-Day Projection: WW 1169645/61852; PRC 82134/3338; NON 1087512/58514; IT 157313/19560; US 477863/6398; TX 9131/162
7-Day Distancing: WW 1169645/61852; PRC 82134/3338; NON 1087512/58514; IT 157313/19560; US 232880/4603; TX 5875/72
7-Day US Prototype: Positive: 134,035 Negative: 728,160 Pending: 100,028 Hospitalized: 68,262 Dead: 4,770 Overrun: 04-06 295-335k
The old formula pushes Texas overrun slightly further out for late-stage events:
04-06 29k TEXAS ICU OVERRUN STAGE 1
04-07 36k TEXAS VENT OVERRUN STAGE 1
04-12 146k TEXAS ICU STG3
04-13 178k TEXAS VENT STG3 & Hosp STG1
04-16 400k may be the inflection point for Texas if 14% like China, but our death rate is lower than theirs or the world.
04-17 532k TEXAS HOSP STG3
04-20 1.2m Inflection point for R0 of 2.2 is 60% with detection rate of 39.08
The new distancing prototype formula looks like this after tweaking:
04-15 2929 TEXAS ICU OVERRUN STAGE 1
04-17 1787 TEXAS VENT OVERRUN STAGE 1
05-02 2929 TEXAS ICU OVERRUN STAGE 3
05-03 1787 TEXAS VENT OVERRUN STAGE 2
05-04 26633 TEXAS HOSPITAL OVERRUN STAGE 1
05-09 4550 TEXAS VENT OVERRUN STAGE 3
05-09 400k may be the inflection point for Texas if 14% like China, but our death rate is lower than theirs or the world.
05-16 26633 TEXAS HOSPITAL OVERRUN STAGE 2
06-05 47441 TEXAS HOSPITAL OVERRUN STAGE 3
05-21 1.2m Inflection point for R0 of 2.2 is 60% with detection rate of 39.08
The growth in hospitalizations puts overrun at 04-06. I do not know what to believe.
Here are the milestones from 04-23 data for comparison to track our progress flattening the curve:
04-06 33k TEXAS ICU OVERRUN STAGE 1
04-07 45k TEXAS VENT OVERRUN STAGE 1
04-10 150k TEXAS VENT/ICU STG2 & Hosp STG 1
04-13 366k TEXAS VENT/ICU STG3 & Hosp STG 2
04-15 660k TEXAS Hosp STG 3
Milestones are based on guesstimates: TX 28.7m pop; 2.9 beds per 1000 in TX (83230); 32% unoccupied (26633) / 11% are ICU (2929); 6.7% ventilators (1787); 10% limited function ventilation (2663) / 5-15% conf need hosp(532k-177k @ overrun); 2-10% ICU (29k-146k); 1-5% need vent (36k-178k)
Testing has ramped up substantially, and the US has a capacity around 350k tests per week, or 50k per day. The increased testing, and the shift in social distancing makes these numbers more fuzzy. I tweaked my multipliers for regression testing.
Our hospital load may be 31.86% of the world average for the same number of confirmed. Korea had 8652 confirmed from 316664 tests on 03-20 with 94 deaths. Their death rate is 1.42%. Ours is 1.44% with 579k tests, 83836 confirmed, 1209 deaths. The world rate is 4.52% I suppose that the death to confirmed case is tied to the test percentage.
Inflection point for R0 of 2.2 is 60% of the population, times the percentage of infected people who get confirmed. It was estimated elsewhere that China at 4.02% mortality rate per confirmed was 14% tested. That means our hospital load will be 35.82% for the same number of confirmed, or that our confirmed cases are 39.08% of our total cases.
TX has 28.7 million, and 39.08% of that is 1.12 million as our inflection point.
Unknown accuracy because testing inputs are changing, and I am just making things up.
Social distancing data lags by 3 days. Statistics lag by 1 day. Detection lags by 9-12 days. Impact delay of SD on Confirmations is 9 days.
https://drive.google.com/file/d/1vocCN445AZyVBBLsv0kJR8ZDP9DM0UST/view
Social Distancing Dashboard
CV19 no big deal
SARS-2 March 24 Update
First, the update:
03-24 Tuesday
1-day Projection: WW 425953/18600; PRC 81595/3283; NON 346031/15382; IT 69104/6744; US 57310/731; TX 916/10
Actual Numbers: WW 417966/18615; PRC 81591/3281; NON 336375/15334; IT 69176/6820; US 53740/706; TX 955/12
03-25 Wednesday
1-day Projection: WW 461807/21005; PRC 81686/3288; NON 381238/17782; IT 74856/7654; US 66137/903; TX 1203/16
Infection spread appears to be reducing in US and TX, even though TX was above projections for yesterday.
US shows 134% instead of 135%, and the last 3 days were 130%, 131%, and 123%.
TX shows 135% instead of 147%, and the last 3 days were 108%, 121%, and 126%.
This implies that the declaration of pandemic may have had positive effect.
The numbers from tonight or tomorrow will start reflecting any changes caused by the declaration of national emergency.
Milestones would have pushed out a day, but my methodology was poor. I now show the number for the condition in the left of the note, not the estimated number for that day. Also, I dropped stage 2 here, and just show worst case reserve (smallest number) and best case reserve (largest number). I do not have proper numbers to separate stage 1 (over standard) vs stage 2 (over minimum reserve).
04-05 29k TEXAS ICU OVERRUN STAGE 1
04-06 36k TEXAS VENT OVERRUN STAGE 1
04-10 146k TEXAS ICU STG3
04-11 178k TEXAS VENT STG3 & Hosp STG1
04-14 400k may be the inflection point for Texas
04-15 532k TEXAS HOSP STG3
Milestones are based on guesstimates, because the exact number of ICU beds and placement of ventillators is proprietary data that is hard to find and confirm. My estimates are based on: TX 28.7m pop; 2.9 beds per 1000 in TX (83230); 32% unoccupied (26633) / 11% are ICU (2929); 6.7% ventilators (1787); 10% limited function ventilation (2663) / 5-15% conf need hosp(532k-177k @ overrun); 2-10% ICU (29k-146k); 1-5% need vent (36k-178k)
Testing infrastructure may fail before the inflection point, leading to a false decrease in numbers reported. If that happens, we may not numerically reach the inflection point, which is 60% of the population for R0 of 2.2. Remember, we only confirm 12-15% of the actual cases, as many are mild or even asymptomatic, but are still infectious to others.
I expect these to move further out each of the next few days, and then it will probably look like it levels off a bit for several days before reducing further.
We are not out of the woods. Hospital usage is 1-4 weeks. Average infection course is 20 days with no hospitalization, but once people are bad enough to need O2 or ventilation, it takes longer to recover well enough to not need it anymore. If we were to fall to 112% today (unrealistic extreme) and stay there, the milestone dates become 04-23, 04-25, 05-07, 05-09, 05-16, 05-18. That spreads out enough that we may gain an extra couple of days on each due to early cases resolving (people do not stay in the hospital forever).
The current milestones for the US, since TX is about 9% of the US:
03-31 29k -> 322k US ICU OVERRUN STAGE 1
03-31 36k -> 400k US VENT OVERRUN STAGE 1
04-05 146k -> 1622k US ICU STG3
04-06 178k -> 1977k US VENT STG3
04-08 400k -> 4444k US inflection point
04-09 532k -> 5800k US HOSP STG 2
These are MUCH more fuzzy, since it is not exactly 9%, and ICU, Vent and bed capacities vary. That adds 1-2 days uncertainty. This also will be affected by any changes in the numbers as discussed above.
Here are the milestones from 04-23 data for comparison to track our progress flattening the curve:
04-06 33k TEXAS ICU OVERRUN STAGE 1
04-07 45k TEXAS VENT OVERRUN STAGE 1
04-10 150k TEXAS VENT/ICU STG2 & Hosp STG 1
04-13 366k TEXAS VENT/ICU STG3 & Hosp STG 2
04-15 660k TEXAS Hosp STG 3
NOTE that the very first milestone was 04-02 based on 570 ICU beds, and was abandoned as a predictor.
When testing and behavior are nonchanging:
Model is +/- 25% per week
That is +/- 1.5 days for stage 1
That is +/- 2.5 days for stage 2
That is +/- 3.5 days for stage 3
Inflection point for R0 of 2.2 is 60%.
Current reporting rate is 12-15%.
Assuming we keep testing by same criteria, the Tx inflection point is 400k confirmed.
We may not reach this numerically due to testing/infrastructure failure.
eg, we may reach stage 3 while our confirmed rate is much lower, but still around the same days.
This is all bistromath, and both reporting rates, and trends are changing daily at this point.
Also note that the numbers lag by up to 24 hours based on reporting systems.
Also Also note that it still takes around 12 days for action changes to affect trends, since people infected today will not be detected for a while.
Also Also Also note that there are many people who have NO symptoms at all, but are still infecting others. This, along with poor testing, explains the 12-15% confirmation rate.
https://drive.google.com/file/d/1vocCN445AZyVBBLsv0kJR8ZDP9DM0UST/view
Overrun Planning
Stats for Sunday, Monday, and predictions for Tuesday, and Texas hospital overruns.
03-22 Sunday
- 7-day Projection: WW 262771/11285; PRC 81266/3324; NON 259371/14696; IT 78550/8986; US 25567/280; TX 521/21. plus or minus 25%.
- 1-day Projection: WW 340729/14895; PRC 81360/3265; NON 260988/11728; IT 61049/5774; US 34015/386; TX 857/5.
- Actual Numbers: WW 335955/14632; PRC 81397/3265; NON 254558/11367; IT 59138/5476; US 33272/417; TX 627/8
03-23 Monday
- 1-day Projection: WW 370630/16503; PRC 81489/3271; NON 290297/13301; IT 65275/6215; US 43432/566; TX 627/13. TX Deaths is Still early and erratic
- Actual Numbers: WW 378287/18600; PRC 81496/3274; NON 296791/13223; IT 63927/6077; US 43667/552; TX 758/9. IT is slowing, which is good. JHU new dataset.
03-24 Tuesday
- 1-day Projection: WW 425,953/18,600; PRC 81,595/3,283; NON 346,031/15,382; IT 69,104/6,744; US 57,310/731; TX 916/10
- Actual Numbers: To be determined. Infection spread for US is fluctuating slightly.
The following major milestones assume no gross change in testing rates nor confirmed infection rates. Stage 1 is over standard capacity. Stage 2 is over worst case reserve capacity. Stage 3 is over best case reserve capacity. This does not cover additional production, but does cover identified lower-function and out-of-date equipment from federal, military, and major hospital stockpiles. At Stage 1, alternative locations are getting converted for use by patients, such as closed medical buildings. At stage 2, we’re relying on medical and nursing students as front-line caregivers, and MASH style pop-up tent hospital expansions start getting deployed where possible. At stage 3, we’re draping parking garages, and getting scouts with first-aid badges to help. Elderly or anyone with comorbidities will be comforted, but won’t get access to mechanical ventilation. Only those with the best chance of survival with, and a high risk of death without, would get advanced care.
- 04-05 33k TEXAS ICU OVERRUN STAGE 1 / 28.7m pop; 2.9 beds per 1000 (83230); 32% unoccupied (26633) / 11% are ICU (2929); 6.7% ventilators (1787) and 10% limited function ventilation (2663) / 5-15% conf need hosp(532k-177k @ overrun); 2-10% ICU (29k-146k); 1-5% need vent (36k-178k)
- 04-06 45k TEXAS VENT OVERRUN STAGE 1 / 28.7m pop; 2.9 beds per 1000 (83230); 32% unoccupied (26633) / 11% are ICU (2929); 6.7% ventilators (1787) and 10% limited function ventilation (2663) / 5-15% conf need hosp(532k-177k @ overrun); 2-10% ICU (29k-146k); 1-5% need vent (36k-178k)
- 04-10 150k TEXAS VENT/ICU STG2 & Hosp STG 1 / 28.7m pop; 2.9 beds per 1000 (83230); 32% unoccupied (26633) / 11% are ICU (2929); 6.7% ventilators (1787) and 10% limited function ventilation (2663) / 5-15% conf need hosp(532k-177k @ overrun); 2-10% ICU (29k-146k); 1-5% need vent (36k-178k)
- 04-13 366k TEXAS VENT/ICU STG3 & Hosp STG 2 / 28.7m pop; 2.9 beds per 1000 (83230); 32% unoccupied (26633) / 11% are ICU (2929); 6.7% ventilators (1787) and 10% limited function ventilation (2663) / 5-15% conf need hosp(532k-177k @ overrun); 2-10% ICU (29k-146k); 1-5% need vent (36k-178k)
- 04-15 660k TEXAS Hosp STG 3 / 28.7m pop; 2.9 beds per 1000 (83230); 32% unoccupied (26633) / 11% are ICU (2929); 6.7% ventilators (1787) and 10% limited function ventilation (2663) / 5-15% conf need hosp(532k-177k @ overrun); 2-10% ICU (29k-146k); 1-5% need vent (36k-178k)
The inflection point for R0 of 2.2 is 60%. Current reporting rate is 12-15%. Assuming we keep testing by same criteria, the Tx inflection point is about 400k confirmed. We may not reach this numerically due to testing/infrastructure failure. eg, we may reach stage 3 while our confirmed rate is much lower, but still around the same day, and still around the same number of actual infected. Also, there are different groups between spreaders and isolators. I don’t know the balance of those two groups. They could be 20/80 or 50/50.
Barring major changes, the model is +/- 25% per week. That is +/- 1.5 days for stage 1. That is +/- 2.5 days for stage 2. That is +/- 3.5 days for stage 3.
If the Pandemic declaration helped, then 03-24 will be at least 2% low for US and TX. If the Emergency declaration helped, then 03-25 will be at least 2% low for US and TX. Either of those should show a continual downward trend. We have had a lot of people ignoring expert and government recommendations, so I do not expect an abrupt change.
If we did abruptly fall to, say, 112% on 03-24 and stay there, then Stage 1 starts April 23-26; then Stage 2 starts May 7-11; Stage 3 may never happen due to average disease cycle of 20 days, and ICU cycle of 30 days. This would be a dream scenario, and is unlikely. More likely to see a 5% drop several days in a row. It’s unlikely to see the clam-down go below 110% until it looks really bad (and then it’s too late).
Texas is about 9% of the US capacity and slightly more capacity than average. Look for 11x numbers in the US column for similar problems.
- 33k -> 363k on 03/30 Stage 1 ICU
- 45k -> 495k on 03/31 Stage 1 Vent
- 150k -> 1650k on 04/04 Stage 2 / Stage 1 Hosp
- 366k -> 4026k on 04/07 Stage 3 / Stage 2 Hosp
- 660k -> 7260k on 04/09 Stage 3 Hosp
112% projections:
- 112% ICU Stage 1 is 04/10
- 112% Vent Stage 1 is 04/12
- 112% V2 / Hosp Stage 1 is 04/23
- 112% V3/H2 is 05/01
- 112% H3 is 05/06
- 112% numbers are +/- 3, 5, and 7 days.
This is all bistromath, and really, anything more than a week out is just guesswork. A lot can change in a week, and I’m expecting substantial changes over the next 3 days based on the activities 10-14 days ago.
The Spreadsheet has been updated. JHU replaced some data sources, so it was a little annoying, and a little more manual entry.
https://drive.google.com/file/d/1vocCN445AZyVBBLsv0kJR8ZDP9DM0UST/view
Projection Spreadsheet
Google link is https://drive.google.com/file/d/1vocCN445AZyVBBLsv0kJR8ZDP9DM0UST/view View/comment only. I don’t know what broke yet, or if everything works right.
Tsunami
I have been maintaining projections on omnitech.net/blog and fb.com/xaminmo .
Basically, it is time to hide from society right now. There are a lot of people still spreading it because it is their right to be free. If you get it now, there will be no resources to help you if you get very sick.
Projections may change by Wednesday, since that is 12 days after the national emergency was declared. If we cut our spread in half, then we get almost an extra week of respite.
Except, I know groups of people who were congregating for public meals as recently as Wednesday, and group exercise just Friday. 6 feet at 14mph is not enough. I don’t have the ability to get people to trust me. Either they see, or they don’t. Plenty actively disbelieve. It’s core to their being to believe exactly opposite of me.
We got complacent, because we’re “not like Italy. Look, they are older, and we were infected sooner. We’re so much better, and our death rate is lower.”
Italy started at +25% per day, and brought it down to +12% per day.
The US started at +5-10%, but for weeks has been spreading at +35% per day. Texas, my state, has to do it bigger. We’re spreading at +47%.
So, April 2, Texas ICU reserve capacity is overrun. A week later, all Texas hospital reserve capacity is overrun. I don’t know where in there we run out of trained medical professionals and supplies to treat safely.
If we did a great job when the pandemic was declared, we get 4-6 more days. A week prior, it will look like a normal day, a little busy, and probably still no toilet paper.
I wish it were not so, but the window of opportunity to change this course is almost closed, and we seem to be accelerating towards it, not slowing.
A tsunami is coming, and we have not even felt the tremor yet.
SARS2 not from a lab
Two bits of info indicating extremely unlikely that this was engineered in a laboratory: A) Computer models show the binding function would be very poor for how it binds; B) The core code of the virus matches animal versions, not versions known to make humans sick.
Here's why: SARS-CoV-2 is very closely related to the virus that causes severe acute respiratory syndrome (SARS), which fanned across the globe nearly 20 years ago. Scientists have studied how SARS-CoV differs from SARS-CoV-2 — with several key letter changes in the genetic code.
Yet in computer simulations, the mutations in SARS-CoV-2 don't seem to work very well at helping the virus bind to human cells. If scientists had deliberately engineered this virus, they wouldn't have chosen mutations that computer models suggest won't work.
https://www.livescience.com/coronavirus-not-human-made-in-lab.html
This evidence for natural evolution was supported by data on SARS-CoV-2’s backbone – its overall molecular structure. If someone were seeking to engineer a new coronavirus as a pathogen, they would have constructed it from the backbone of a virus known to cause illness. But the scientists found that the SARS-CoV-2 backbone differed substantially from those of already known coronaviruses and mostly resembled related viruses found in bats and pangolins.
https://www.scripps.edu/news-and-events/press-room/2020/20200317-andersen-covid-19-coronavirus.html
Mortality vs Economy
Some discussions around the risk of increased mortality from the economic shutdown, vs the increased risk of mortality from COVID-19. This seems like a relevant answer: “Of the six causes of death accounting for over 2/3 of mortality during the Great Depression, only suicides increased.”
https://www.pnas.org/content/106/41/17290