1/ It's time to look at week 16 (April 12-April 18) #COVIDView
Are things getting better or worse overall in the US?
Are there pockets of concern or good news?
What new data have we gotten in the past week?
How would an epidemiologist look at the data?https://twitter.com/Farzad_MD/status/1251272054986416128?s=20 …
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12/ If you're panning for gold (+ cases) and every 5th time you took your pan out of the river you find a gold nugget, you know that there's a rich vein where that came from. That's what this is saying. We'll know we're doing a good job when it becomes HARD to find a + case
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13/ Now, those are official CDC results.
@covidtracking has more updated data (though probably less reliable) scraped from each state- they show an increase in testing in Week 17, and a dip in positivity rate
NY (39%->28%)
MI (28%->18%)
are continuing to see drops
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14/ But there are also a number of states on that seem to be having increases in percent positivity. DE 25%->34% ?? OH 15%->19% IA 15%->20% NE 10%->19% KS 9%->16% Do you see a pattern in those supposedly safe homeland states? Not time to reopen
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15/ Speaking of reopening- here are some notes on who's announced reopening plans: Most famously,
@GovKemp who's been roundly criticized, including by Trump, and rightly so (no decline in cases, several worrisome counties, >15% positivity rate) https://thehill.com/homenews/state-watch/493717-heres-when-all-50-states-plan-to-reopen-after-coronavirus-restrictions …pic.twitter.com/kYdQYOwU5e
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16/ Which brings us to syndromic surveillance (be still my heart) The national rates of ED visits (NSSP) and ambulatory visits (ILINet) with symptoms compatible with COVID19 continue to drop. That's good. But averages can be deceiving- what about the state/local level?pic.twitter.com/fcBGzojBRc
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17/ The Sentinel ILI sites seem to be dropping, though still a few hotspots parenthetically, it's nuts that we don't have lab testing for COVID at these sentinel sites so we could actually know what percent of those "ILI" visits were actually COVID. Give em tests+PPE, & Pay em!pic.twitter.com/XQd0kzZntP
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18/ The other problem w Sentinel ILI is that there are too few sites to get good geographic granularity- you don't get much info on the people w ILI, like their zip codes. (also hard to investigate spikes) This is where ED syndromic shines. But guess what? No state maps/graphs
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19/ If we're going to rely on this data for closures and reopening, then every state should have this on their websites every day some do: MI https://www.michigan.gov/coronavirus/0,9753,7-406-98163_98173_99449---,00.html … AZ https://www.azdhs.gov/preparedness/epidemiology-disease-control/infectious-disease-epidemiology/covid-19/dashboards/index.php … NC https://www.ncdhhs.gov/divisions/public-health/covid19/covid-19-nc-case-count#surveillance-report … FL https://floridadisaster.org/globalassets/covid19/dailies/covid-19-data---daily-report-2020-04-23-1638.pdf … ID https://public.tableau.com/profile/idaho.division.of.public.health#!/vizhome/DPHIdahoCOVID-19Dashboard_V2/Story1 …
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20/ Finally, instead of looking at just COVID-ILI recorded deaths, we should also be looking at "Pneumonia and Influenza" deaths, in case COVID is under-diagnosed. There's good evidence (public soon!) of increases in P&I deaths prior to recognized outbreaks in several statespic.twitter.com/FBY29Jn2ui
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21/ So what kind of forecast would I give the US right now? Americans' extraordinary physical distancing has -for the time being- calmed down the storm substantially, but there are millions of infectious people, and pockets of real concern if reopening happens too soon, too fastpic.twitter.com/zbUi5fhIJR
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