Tag Archives: us
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 This does not cover additional production, but does cover identified lower-function and out-of-date equipment from federal, military, and major hospital stockpiles.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
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.
US death rates
US death rate is low and falling. It is so far lower than everywhere else, I strongly suspect that the dead are not being tested for the virus, and only if they were already tested would they be considered a SARS-2 death.
In reality, the death rate we’re looking at is per infected person, and that is a false-low. Plenty of infected people have time yet to die. You have to plot it based on deaths per recovered person to get a true value. Since we are not done with the outbreak, and the US is still pretty early into the big numbers, that mortality rate is artificially high. China is 4.0 for mortality per all, and 4.37 for mortality per recovered. The US is 1.28% and 62.4% respectively.
It is more likely that the US infection rate is so high that not enough people have had time to die. I think in the next week, we’ll begin to see larger numbers of US CV19 patients dying. Also note that the US infection rates have dramatically risen the last 2 days. This may reflect an improvement in testing ability and reporting.
The alternative is that we’re accelerating due to people disbelieving the quarantine. I still see that locally in the Flower Mound area. Mid-week, people were still gathering for group meals, and group outdoor exercise. 6 foot spacing is not sufficient when you’re downwind from someone, such as when you are moving 10-15mph in a straight line.
Where Cases Deaths Recovered Mort/A Mort/R World 272,167 11,299 87,403 4.15% 11.45% China 81,250 3,253 71,266 4.00% 4.37% Non-China 190,917 8,046 16,137 4.21% 33.27% Italy 47,021 4,032 4,440 8.57% 47.59% US 19,101 244 147 1.28% 62.40% Texas 394 1 0 0.25% 100.00% France 12,632 450 12 3.56% 97.40% United Kingdom 4,014 178 67 4.43% 72.65%
Mortality rates all vs recovered are 3.56/97.4 for France, and 4.43/72.65 for UK. More in line with everyone else. Again, too early for the mortality per recovered person to make much sense.
Current 7-day average daily change rates for deaths in US, FR, and UK are 145.75%, 174.69%, and 160.33% respectively.
Daily Change Avg 7 Days World 113.75% China 100.18% Non-China 121.04% Italy 116.38% US 145.75% Texas 133.33% France 174.69% United Kingdom 160.33%
Current 7-day average daily change rates for confirmed cases in US, FR and UK are 157.69%, 118.24%, and 125.30%. In other words, the US is spreading the infection at double the rate of the UK, and three times France.
Daily Change Avg 7 Days World 112.54% China 100.09% Non-China 119.46% Italy 114.74% US 157.69% Texas 150.91% France 118.24% United Kingdom 125.30%
That is in line with predictions that our death rates look lower because we’re spreading faster, and people have not had time to die yet.