It has never been possible to determine for sure how many people in the United States are ill with COVID-19 at a given time. Instead, we combine all the metrics – the percentage of tests run that come back positive, the number of new cases reported each day, people coming to the sick emergency room with COVID-19 symptoms – to get an estimate. It’s like the story of the blind men and the elephant: experts can peel out the various pieces of information to understand what a revolution looks like, even when they can’t see directly.
We have seen the same elephant appear over and over again over the past year. First, the percentage of returning tests increases exponentially. After a short delay, hospitals begin to rise, followed by deaths. But this time, there’s a new label: vaccines. That is going to change the pattern and make the COVID-19 trends over the next few weeks and months more difficult to explain.
One of the most important data points for monitoring the spread of the virus is the number of people who were hospitalized with a COVID-19-like illness at a given time. It is a concrete metric. If someone is so ill that they have to go to hospital, they will usually be in hospital. Other measures, such as case level and trial confirmation stage, are finicky; they vary depending on how many people decide to take a test.
“Hospitals are our hard work. Everything else is so much about testing, ”said Melissa McPheeters, co-director of the Center for the Development of Public Health through Informatics at Vanderbilt University. That’s why we looked at hospital trends to understand the direction of the pandemic, even as case levels shift.
Now, COVID-19 cases are starting to pick up again in the United States. But this time, more than 70 percent of people over 65 in the United States have received the first dose of the COVID-19 vaccine. That is the group that, if they catch the virus, is more likely to go into hospital or die. Now they are getting the vaccine – and the risk of going to hospital and dying is very small.
That could throw our normal data patterns out of whack. Things could go awry as many states are resting while most people are not yet getting the vaccine. But the unvaccinated people who become ill may be younger and less likely to be hospitalized.
Our normal way of seeing the elephant would no longer be working. It’s a good problem – fewer people in the hospital is an incredible win. But as case numbers move and fluctuate, hospitals will no longer be a reliable back-up to clarify what is happening with the pandemic. “I don’t know if we can get such a good sample of what’s going on in the community,” McPheeters says.
It may mean that we need to rebalance the way we monitor pandemic. There may be fewer people in the hospital, but we could take a closer look at that group, for example. If there are a lot of people from one area of a city in the hospital, or people who work in a similar industry, that could be a sign that there is more virus in that particular community – which people could help identify the risk and show officers where resources should be directed. “It’s not just how many people there are Who ending up in hospital, ”McPheeters says.
For the past year, people have studied COVID-19 meters to guide decisions on how they should behave – whether to send children to school, meet a few friends, or get food delivered. Finally, as more people receive the vaccine, new patterns may emerge that may guide that analysis. And when pandemic begins to decline, we do not need to study COVID-19 numbers in such detail. But for now, everything is growing, and we cannot accept that number means the same thing today as it did in January.
Here’s what else happened this week.
Research
Covid Code Solution
Take a deep dive into the world of genetic sequencing – and explore how this tool could change public health in a post-pandemic world. (Jon Gertner / The New York Times)
No one can find the animal that gave him COVID-19
Groups are searching for the animal that first transmitted the virus that causes COVID-19 to humans, starting the pandemic. It is not an easy task, and international politics makes it much more difficult. (Anthony Regalado / MIT Tech Review)
Development
AstraZeneca’s wild ride
On Monday, AstraZeneca announced that its vaccine was 79 percent effective. The next day, the government issued a very unusual public recall of the company, saying those numbers were outdated. AstraZeneca released new figures later in the week finding it was actually 76 percent effective. Whew. Ultimately, it is a very good vaccine with severe communication difficulty. FDA committee hearings for this one are going to be interesting. (Nicole Wetsman / The edge)
Pfizer will begin testing its vaccine in young children
Children under 12 are beginning to participate in clinical trials for COVID-19 vaccines. Pfizer and Moderna are both embarking on their own tests to test how well the vaccines work in younger patients – and whether they are safe. (Apoorva Mandavilli / The New York Times)
Here is a great video from our colleagues at Vox explaining the differences between vaccine efficacy numbers.
Comments
The two weeks were in the summer when she could only smell smoke. The smell was so strong that she woke up one morning, pretending that something in her house was on fire. Some time later, she smelled her boyfriend ‘s cologne again – but instead of the familiar scent she had always liked, it was a sickly chemical smell. The work also has the hand soap, which used to smell like standard fruit but now smells directly, and happily, like Burger King Whoppers.
– Sarah Zhang writes about Ruby Martinez’s experience regaining her sense of smell after COVID-19 was introduced The West Bay.
As of Dec. 10, my health care plan had sent me a bill for $ 536,000. My plan paid for most of it, but I’m still around $ 150,000. That doesn’t include my bill for the implant. The medical bills are weakening; it will take months for things to come through. At first, it was a concern for me to take a look at them, but now it ‘s a joke. I look at them and think, I don’t know how to pay that. My price is $ 750 a month, and my colleagues have been sinking in to cover that.
– Liza Fisher tells journalist Wudan Yan about the costs of COVID-19 in a story for Intelligencer.
More on numbers
To more than 505 million people who have been vaccinated – thank you.
For more than 125,864,307 people worldwide who have tested positive, your road to recovery may be smooth.
To the families and friends of the 2,761,409 people who have died worldwide – 547,756 of those in the US – your loved ones are not forgotten.
Stay safe, everyone.