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Minnesota Covid Trends: Positive Tests and Mortality Rates

Discussion in 'Current Events' started by Wandering Monk, May 20, 2020.

  1. Wandering Monk

    Wandering Monk Well-Known Member

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    I have been doing daily analysis of data from the Minnesota Department of Health looking for trends in Covid.

    Trying to determine the fatalities per case is very difficult because we don't know how many people have contracted the virus but had no symptoms or very mild ones that did not require medical attention and so did not get counted.

    Minnesota has been tracking numbers of tests and results since late March. It is important to note that these tests were for people suspected of having Covid at the time they were tested, NOT people who may have had it and recovered.

    Deaths were derived from death certificates. In early days, before tests were widely available, they left it up to the doctors judgement whether to report deaths as Covid or not, based on the symptoms and their best clinical judgement. (In the UK, high fever and dry cough were symptoms in 99% of people who died from Covid. They have since added 'loss of sense of smell to the list.) Since May 13, Minnesota has been separating out 'presumed' Covid cases from their case data and going with actual tests results. PLEASE LEAVE POLITICS OUT OF THIS DISCUSSION!

    We will not know what percentage of people who contracted the virus actually died from it until enough people have been tested for antibodies that a reasonably accurate projection can be made. The antibody test is different than the test for Covid in patients. The antibody test only tells you if you have had it in the past, not if you are currently infected.

    This chart therefore only represents the cases that have been found in people who were suspected of having the virus and who took the tests. This is based on the total number of tests for Covid over time.

    You can see that the fatality rate is stubbornly stuck around 4% of positive tests and that positive tests are around 11% of total tests.

    Of those who died, 80% were in Long Term Care or Assisted Living facilities.

    The confusing thing about this is that the % of positive cases has been declining since early May. Lately states have been reporting an excess of unused test kits. They are telling people to get tested only if they have symptoms. Does this decline mean that fewer people are having symptoms (a decline in infections) or does it mean something else?

    Curiously, I was watching the daily British government briefings on Covid, and their rates are very close to these percentages.
     

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    #1 Wandering Monk, May 20, 2020
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  2. exchemist

    exchemist Well-Known Member

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    Did Minnesota impose social distancing and other control measures and if so from what date? It seems to me one needs to know this in order to interpret the changes you mention.

    There can also be a timing issue. The rule of thumb I have used for UK data is that there is an incubation period of a week, and that those people who are only tested upon admission to hospital (which were almost the only ones being tested in the UK until very recently) would get tested after suffering for about 2 weeks. So the test data based on hospital admissions lags the infection rate by 3 weeks or so. (Those that die do so ~ a week after admission to hospital so death data lags infection rate by about 4 weeks.) It therefore matters what it is that triggers a test to be done in Minnesota. Have people got tested as soon as they feel they have symptoms, and if so how soon do their results come back? Or is it only when they get to hospital as a bad case? Or some mixture of the two?
     
  3. Wandering Monk

    Wandering Monk Well-Known Member

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    Our Governor instituted the stay at home order on March 25.

    Our lags are about the same as those you suggested.

    Early days, we didn't have test kits so it was based on physician judgement based on symptoms (dry cough, high fever.) Most of these were probably found in a clinical setting. Don't know how long for results. I have heard 48 hours bandied about.

    At the press conference today, he was frustrated that more people aren't getting tested, but then says only get the test if you have symptoms. Does that mean fewer people are having symptoms? Can't figure it.

    Also, the Feds poached a bunch of reagents produced in Minnesota for Minnesota.

    A final bit. If you look at the case mortality rate by comparing total deaths to total test (not just total positive tests) the case fatality rate is about 0.45%. The state is not expected to peak, however until late July or early August.
     
    #3 Wandering Monk, May 20, 2020
    Last edited: May 20, 2020
  4. sun rise

    sun rise "Let there be peace and love among all"
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    The numbers are, as the OP points out, problematical. Even today when COVID-19 should be listed as one of the causes of death, it does not always happen. Someone might have a heart attack while sick with the virus, but what's listed could be only the heart attack or both depending on the state and locality.

    California has been ramping up tests on a regular basis and our infected count is not going down but this could be due to more people being tested.

    And the death toll could be going down because we're getting better at treating the virus especially if there's a cytokine storm for example.

    But I think we can draw rough conclusions especially if we ignore a few Republican states where the numbers are being fudged for political ends.
     
  5. exchemist

    exchemist Well-Known Member

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    So maybe less of a time lag than if based on acute hospital admissions, perhaps 2 weeks on average? In which case the curve ought to start responding about the end of the 1st week in April. But it doesn't, apparently, until the end of the month. So maybe that is because the basis on which people were tested was changing during that time (more testing being done?), obscuring the trend. The deaths, though, ought to have a fixed relationship to the infection rate and should start to respond about 4 weeks after the stay at home order. Arguably this is what has happened, isn't it?

    But I'm a bit mystified by the forecast of a peak in July/August. The goal of the stay at home order is presumably to bring R down to below 1, so that the epidemic slows and starts to die away. While it takes time for the curve to flatten out and reach the peak before starting to decline, I'd be surprised if it took that long, unless perhaps the stay at home order only brings R down to just below 1.

    The trouble with all this is that there are a lot of moving parts and estimating R seem to be notoriously difficult.

    The new hospital cases in London are now down to 20-25/day apparently, and people talk of R being as low as 0.4. But now that they are starting to lift some of the controls there is risk of it gong back above 1 again, which would undo all the sacrifices we have made. I fear Bozo will get impatient and blow it.
     
  6. Wandering Monk

    Wandering Monk Well-Known Member

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    Don't know what our R value is. The governor has pretty high approvals for his handling of this, and polls seem to indicate that in the US, more than 80% have concern about opening too fast.
     
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