Yesterday’s post about the dichotomy between increasing COVID-19 infections and decreasing deaths has generated a number of interesting responses. I will try to respond to a few of them now.

DN writes

“Dr Baker — my understanding of the process in my state (Arizona) is that diagnoses are reported on one track and deaths on a different track, and that reporting of death may lag considerably behind the actual event because of delays in issuance of death certificates. Current news reports quote local hospitals as saying that, for the first time, they are at or near capacity (beds/personnel/supplies) for COVID-19 patients.”

While death reports lag illness, COVID-19 is a public health reportable disease, so the delay is not that great. If you look at overall activity in Arizona it is not near capacity; however, there may be clusters or outbreaks in certain areas that alter the dynamic. I agree we need to continue to monitor these numbers even though deaths have continued to drop for six weeks.

Neal writes

what if simply deaths are lagging infections by 20-30 days, as that’s the time it takes to be detected, progress in severity, go to ICU, receive ventilator support and then recover or die?

If this were the case we would have already seen increases in hospitalizations. We have not. Again, we should continue to monitor the numbers regardless.

Gus writes

We were fortunate that we had an intelligent Governor (in Michigan) who did what needed to be done when it had to be done. Floridians and Texans have not been so fortunate. They are in lockstep with President Trump, and still think this is all a conspiracy theory created by the Democrats to undermine the stock market. If Florida and Texas do not get their act together, they will be the States that will be undermining the stock market and they will sink the President’s re-election campaign. For the sake of all the doctors, nurses and patients -and for the sake of our entire nation- I hope they realize how dumb they have been -and get their act together!

Gus. I think we need to continue to watch the numbers and see what happens in several of the southern states. The SE Michigan outbreak was severe and demanded a response. Deaths in places like Texas have not approached anything like what was see in the northeast or Michigan per capita. Given the different circumstances it remains to be seen if any of these states have an outbreak comparable to Michigan. If they do, they will need to respond.

Thanks to everyone and their feedback!

Published by jbakerjrblog

Immunologist, former Army MD, former head of allergy and clinical immunology at University of Michigan, vaccine developer and opinionated guy.

2 thoughts on “Feedback

  1. Thanks for the response. I believe hospitalizations have been rising rapidly in certain states (Texas, Florida, Arizona, etc.) but the hospitalization data is not tracked at a national level as well as case count or deaths, so the nat’l press may be less aware. Locally here in North Carolina, hospitalizations are at peaks, and friends in Texas report ICUs are full in Houston and other areas. Below are some links to regional data. In 2-3 weeks, I fear that the death count may jump, unless these hospitalizations represent a younger cohort than the prior wave in Mar/Apr or have different clinical outcomes due to better treatment.


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