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Fitch
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In reply to AgLiving06 • 8:22a, 7/13/20
AG
Best I can tell all case reports published by the Texas Department of State Health Services (my data source) are as of the date test results were received, not when the actual test was taken.

Depending on where a test is performed it's taking anywhere from a few hours to more than two weeks to turn around test results. There are some public agencies which are backdating cases to test dates, but that subjects the data to being constantly revised. The State just publishes a snapshot as of cutoff each day.
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BiochemAg97
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In reply to AgsMyDude • 10:14a, 7/13/20
AG
AgsMyDude said:
BiochemAg97 said:
Aust Ag said:
Austin hospitalizations flattening?
Won't be for long. They have already been asking to move RGV COVID cases up to Austin. Guess They sent all they could to SA already.

Do you have any credible info on this? I saw a random post of reddit talking about the same idea.
https://www.statesman.com/news/20200710/texas-cities-want-to-send-covid-patients-to-austin-ndash-but-is-space-available

I have no idea about SA, merely speculation. But it doesn't make sense to transfer cases to Austin if you can transfer to SA. Presumably, you would seek the closest hospitals first and then go further when that option is closed.
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BiochemAg97
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In reply to AgLiving06 • 10:16a, 7/13/20
AG
AgLiving06 said:
Question.

Are the numbers being reported the day they confirmed the positive test or the day that the test was taken?

I know a buddy of mine has been waiting at least a week for his results, but is presumptive positive.

Assuming they tell him today he's positive, will that count in today's numbers or last weeks numbers?
Possibly both. CDC guidance appears to require counting presumptive positive as COVID cases.
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MBAR
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In reply to BiochemAg97 • 3:39p, 7/13/20
AG
BiochemAg97 said:
dragmagpuff said:
Bert315 said:
terradactylexpress said:
That chart is also several days old and yesterday was the highest case count so far....


You have to remember that the positive tests the media keeps pushing includes people retesting to see if still positive. We are seeing a plateau in the number of new cases which means this week we should see the same in admissions for Houston area hospitals. The hospital I work in believes we should see our peak in hospitalizations middle of this week at the latest in Houston. This all hangs in whether people socially distanced during the July 4th holiday.
Based on metrics of:
  • Apple/Google Maps requests
  • Opentable reservation requests

Texas was already increasing their social distancing once the hospitals got out there and started saying things like "Please stop being idiots", and "Please wear a mask" so we don't get overwhelmed. This was before the governor's executive orders to close bars and mandate masks.
Wait, you mean people can think for themselves and don't have to wait for the govt to tell them what to do?
One look at the charts across this country tells me all I need to know about people making good decisions for themselves AND OTHERS regarding COVID.

YMMV.
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Fitch
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5:07p, 7/13/20
AG
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PJYoung
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5:14p, 7/13/20
AG
Approaching burnout rate? (Fingers crossed)
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AgsMyDude
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In reply to BiochemAg97 • 5:20p, 7/13/20
AG
Found the post, this is purse internet specultation
https://www.reddit.com/r/sanantonio/comments/ho6dx1/san_antonio_has_more_covid19_hospitalizations/fxh3x5w/

Quote:
Made small talk with an infectious disease Dr today at one of the hospitals on my route. As we were going up in the elevator this Dr told me that about half of all patients currently hospitalized with Covid in San Antonio came from outside counties with small hospital systems. Covid positive testing rates are high here but the numbers are made up from Bexar county residents, people who live outside Bexar county but got tested inside Bexar county hospitals once transported and those who live outside Bexar but work within and got tested here.

I made a comment about how that doesn't get reported and how it puts a negative stigma on San Antonio in the media. The Dr agreed but said the media would have no way of knowing origin of residence for every patient due to HIPPA laws. The Dr said some of these counties have one hospital for the entire county with maybe 5 ICU beds total. Since San Antonio has such a huge hospital system, people are getting transported here from everywhere. Bottom line, Bexar county residents are not as sick as the numbers show.

Another replied

Quote:
I'd have to agree with this. In my unit 50-75% of our patients month to month are transports from cities outside of San Antonio.


Interesting if true
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aggiemike02
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In reply to AgsMyDude • 5:55p, 7/13/20
AG
this is and has been happening around the country. smaller/rural areas are not equipped or simply do not have ICU's
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PJYoung
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In reply to aggiemike02 • 6:04p, 7/13/20
AG
aggiemike02 said:
this is and has been happening around the country. smaller/rural areas are not equipped or simply do not have ICU's

On here Marcus has talked about it happening in Birmingham
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74Ag1
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In reply to PJYoung • 6:38p, 7/13/20
AG
PJYoung said:
Approaching burnout rate? (Fingers crossed)

What is the burnout rate?
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rojo_ag
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In reply to 74Ag1 • 6:51p, 7/13/20
AG
74Ag1 said:
PJYoung said:
Approaching burnout rate? (Fingers crossed)

What is the burnout rate?
I found this article.

20% infection?

https://theconversation.com/coronavirus-could-it-be-burning-out-after-20-of-a-population-is-infected-141584
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74Ag1
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In reply to rojo_ag • 6:58p, 7/13/20
AG
Thanks
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Sq 17
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7:26p, 7/13/20
Burnout rate seems to be real and Takes place at a 20% infection rate
My WAG is the burn out happens because the local population gets very serious about mitigation and not some kind of herd immunity affect.
Hopeing herd immunity/burnout rate kicks in at 20%
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Keegan99
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In reply to Sq 17 • 8:07p, 7/13/20
AG
Sq 17 said:
Burnout rate seems to be real and Takes place at a 20% infection rate
My WAG is the burn out happens because the local population gets very serious about mitigation and not some kind of herd immunity affect.
Hopeing herd immunity/burnout rate kicks in at 20%


This would be very unlikely.

It has occurred in Europe regardless of public policy prescriptions and societal behaviors.

I would suggest checking in on Michael Levitt's Twitter feed.
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74Ag1
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In reply to Keegan99 • 8:15p, 7/13/20
AG
Keegan99 said:
Sq 17 said:
Burnout rate seems to be real and Takes place at a 20% infection rate
My WAG is the burn out happens because the local population gets very serious about mitigation and not some kind of herd immunity affect.
Hopeing herd immunity/burnout rate kicks in at 20%


This would be very unlikely.

It has occurred in Europe regardless of public policy prescriptions and societal behaviors.

I would suggest checking in on Michael Levitt's Twitter feed.

Thanks don't twitter.
So it burned out over time without policy prescriptions? (like social distance, masks, etc)
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74Ag1
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In reply to Keegan99 • 8:31p, 7/13/20
AG
Keegan99 said:
Sq 17 said:
Burnout rate seems to be real and Takes place at a 20% infection rate
My WAG is the burn out happens because the local population gets very serious about mitigation and not some kind of herd immunity affect.
Hopeing herd immunity/burnout rate kicks in at 20%


This would be very unlikely.

It has occurred in Europe regardless of public policy prescriptions and societal behaviors.

I would suggest checking in on Michael Levitt's Twitter feed.

Haven't seen this video about 1 month ago
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BiochemAg97
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In reply to 74Ag1 • 8:42p, 7/13/20
AG
74Ag1 said:
Keegan99 said:
Sq 17 said:
Burnout rate seems to be real and Takes place at a 20% infection rate
My WAG is the burn out happens because the local population gets very serious about mitigation and not some kind of herd immunity affect.
Hopeing herd immunity/burnout rate kicks in at 20%


This would be very unlikely.

It has occurred in Europe regardless of public policy prescriptions and societal behaviors.

I would suggest checking in on Michael Levitt's Twitter feed.

Thanks don't twitter.
So it burned out over time without policy prescriptions? (like social distance, masks, etc)
The data suggest the duration of the peak is independent of control methods.

The problem with most of the US right now is we locked down and never allowed the virus to run it's course. We successfully flattened the curve and the result (as everyone knew from the beginning) was to shift the pick from then until later. There is value in that (more knowledge, better treatment), but somehow along the way we forgot what flattening the curve really meant.

Even those fanciful graphs from the British guy that said we would have a crazy number of deaths showed and that it would save lives if we locked down and flattened the curve showed the return in a second wave at the end of lockdown. Unfortunately, they only graphed out to the beginning of that second upward curve and cut off the actually peak that would have occurred later. Convenient for the politicians wanting to shut the world down to hide the fact that the deaths were just delayed and not prevented.
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74Ag1
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In reply to BiochemAg97 • 9:34p, 7/13/20
AG
This thing moved in waves. The US shut down while NY/NY were exploding and controlling the whole USA. We were in pretty good shape then the riots/protests pushed it up... then the RGV wave to Houston and other metro areas.
Hopefully the trend peaks and starts moving down again
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Pasquale Liucci
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In reply to 74Ag1 • 9:34p, 7/13/20
AG
Yes exactly. Levitt has theorized there is some sort of innate or acquired T cell immunity in a portion of the population. That hypothesis is a result of analyzing shape of outbreaks across the world that plays out in a Gompertz curve. Basically countries seem to reach an asymptote way before theoretical herd immunity is reached.
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BiochemAg97
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In reply to Pasquale Liucci • 9:45p, 7/13/20
AG
Lester Freamon said:
Yes exactly. Levitt has theorized there is some sort of innate or acquired T cell immunity in a portion of the population. That hypothesis is a result of analyzing shape of outbreaks across the world that plays out in a Gompertz curve. Basically countries seem to reach an asymptote way before theoretical herd immunity is reached.
There is actually a study underway to look at T cell and B cell mediated immunity to COVID. The assumption is that T cells and B cells in some people have receptors that recognize COVID virus. People who are asymptomatic of have milder disease should have these receptor while people who get really sick don't have much if any receptors to bind COVID virus. Thus, there should be genetic sequence differences in B-cell and T-cell receptors that correlates with disease severity.

The hope is a diagnostic test to indicate who would be at high risk due to reduced innate immunity. Conceivably, those individuals would benefit most from vaccinations and early or more aggressive treatment.

https://www.roswellpark.org/newsroom/202004-roswell-park-catholic-health-university-buffalo-unite-answer-question-who-will
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culdeus
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In reply to Sq 17 • 9:21a, 7/14/20
AG
Sq 17 said:
Burnout rate seems to be real and Takes place at a 20% infection rate
My WAG is the burn out happens because the local population gets very serious about mitigation and not some kind of herd immunity affect.
Hopeing herd immunity/burnout rate kicks in at 20%
This seems likely. Some people don't need to be told to do the right thing by their mommy. They do it on their own to help others. Thinking that this disease naturally expires at 20% is just as likely to me as that is the threshold at which people start to care.
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Cepe
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In reply to BiochemAg97 • 9:44a, 7/14/20
AG
BiochemAg97 said:
74Ag1 said:
Keegan99 said:
Sq 17 said:
Burnout rate seems to be real and Takes place at a 20% infection rate
My WAG is the burn out happens because the local population gets very serious about mitigation and not some kind of herd immunity affect.
Hopeing herd immunity/burnout rate kicks in at 20%


This would be very unlikely.

It has occurred in Europe regardless of public policy prescriptions and societal behaviors.

I would suggest checking in on Michael Levitt's Twitter feed.

Thanks don't twitter.
So it burned out over time without policy prescriptions? (like social distance, masks, etc)
The data suggest the duration of the peak is independent of control methods.

The problem with most of the US right now is we locked down and never allowed the virus to run it's course. We successfully flattened the curve and the result (as everyone knew from the beginning) was to shift the pick from then until later. There is value in that (more knowledge, better treatment), but somehow along the way we forgot what flattening the curve really meant.

Even those fanciful graphs from the British guy that said we would have a crazy number of deaths showed and that it would save lives if we locked down and flattened the curve showed the return in a second wave at the end of lockdown. Unfortunately, they only graphed out to the beginning of that second upward curve and cut off the actually peak that would have occurred later. Convenient for the politicians wanting to shut the world down to hide the fact that the deaths were just delayed and not prevented.
Very good summary I think. The intent to flatten the curve was real and very good policy IMO. And we did it. But I don't think anybody expected the curve not to spike when things opened back up. The question is how much and how fast did it go up and did we need to flatten it again. With the numbers, the answer is yes.

But each time we open up the spike should be less and less and should be managed that way IMO.

The problem is so many leaders try to outhink the next person and it just spirals and people tune them out.

The country was quarantined because the people agreed, not because some politician mandated something. If we need to do it again people need to be convinced to do it. otherwise, people will just ignore it IMO.
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Keegan99
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In reply to culdeus • 9:45a, 7/14/20
AG
Except those numbers held in Wuhan. They held on the Diamond Princess. They've held throughout Europe.

Vastly different cultures and responses.
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Pasquale Liucci
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In reply to Keegan99 • 9:52a, 7/14/20
AG
Keegan99 said:
Except those numbers held in Wuhan. They held on the Diamond Princess. They've held throughout Europe.

Vastly different cultures and responses.
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Complete Idiot
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In reply to Keegan99 • 10:46a, 7/14/20
Keegan99 said:
Except those numbers held in Wuhan. They held on the Diamond Princess. They've held throughout Europe.

Vastly different cultures and responses.
And how was it determined there was a 20% infections rate in Wuhan, Diamond Princess, and Europe? Antibody testing or estimates/models? Only DIamond Princess had "active virus" testing for all passengers and showed that 20%, roughly, were infected. Of course each of those areas entered a lockdown and remained in lockdown, or have slowly emerged with changed behaviors. I've seen some antibody test results in Italy and NYC that suggested 20% or more had antibodies, but nothing close to that from Wuhan. And a very large Spain study showed 5%.
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Keegan99
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In reply to Complete Idiot • 11:26a, 7/14/20
AG
It's done with estimates / models, largely from fatality figures. The serology studies are coming under increasing suspicion since we now know there are a large number of infections that do not produce detectable levels of antibodies.

Note that a PFR of ~0.05% and an IFR of ~0.26% points to ~20% burnout threshold. And holding PFR constant and increasing the IFR points to a lower burnout threshold.

As for lockdown, Sweden produced a comparable curve to elsewhere in Europe despite vastly different policies.

Here's Sweden vs UK:



Backdating the fatality curve by disease progression, one can observe that infections peaked in the UK and began dropping *prior* to lockdown and other harsh policy prescriptions.

The outliers globally? The NYC metro area, where population fatality rates were over 1000 per million. One can make their own conclusions about how policies related to long term care facilities may have influenced that figure
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JB!98
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In reply to AgsMyDude • 3:32p, 7/14/20
AG
AgsMyDude said:
Found the post, this is purse internet specultation
https://www.reddit.com/r/sanantonio/comments/ho6dx1/san_antonio_has_more_covid19_hospitalizations/fxh3x5w/

Quote:
Made small talk with an infectious disease Dr today at one of the hospitals on my route. As we were going up in the elevator this Dr told me that about half of all patients currently hospitalized with Covid in San Antonio came from outside counties with small hospital systems. Covid positive testing rates are high here but the numbers are made up from Bexar county residents, people who live outside Bexar county but got tested inside Bexar county hospitals once transported and those who live outside Bexar but work within and got tested here.

I made a comment about how that doesn't get reported and how it puts a negative stigma on San Antonio in the media. The Dr agreed but said the media would have no way of knowing origin of residence for every patient due to HIPPA laws. The Dr said some of these counties have one hospital for the entire county with maybe 5 ICU beds total. Since San Antonio has such a huge hospital system, people are getting transported here from everywhere. Bottom line, Bexar county residents are not as sick as the numbers show.

Another replied

Quote:
I'd have to agree with this. In my unit 50-75% of our patients month to month are transports from cities outside of San Antonio.


Interesting if true
This is true. My source at a large hospital in SA has confirmed it. Also, I live in a county outside of Bexar. I know of two folks from my circle of friends that are in an SA hospital with the virus.

My question would be that if you die in Bexar County of or with the virus, is it counted as a Bexar County death? My wife and I know of two folks who died with it in a SA hospital and the fatality numbers in our county have not changed.
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AgsMyDude
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3:45p, 7/14/20
AG
Bexar county continues to look like it's flattening




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Aust Ag
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In reply to AgsMyDude • 6:05p, 7/14/20
AG
If we only knew how many of those Bexar county deaths were to it's residents....
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Dr. Not Yet Dr. Ag
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In reply to Aust Ag • 6:19p, 7/14/20
Why, "if only"? They don't include deaths of individuals from other counties. If someone from Kendall County dies in a Bexar County Hospital, that death is only included in Kendall County stats, not Bexar County.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
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goodAg80
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In reply to Dr. Not Yet Dr. Ag • 6:27p, 7/14/20
AG
Dr. Not Yet Dr. Ag said:
Why, "if only"? They don't include deaths of individuals from other counties. If someone from Kendall County dies in a Bexar County Hospital, that death is only included in Kendall County stats, not Bexar County.
I think he is talking about non-US citizens.
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Dr. Not Yet Dr. Ag
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In reply to goodAg80 • 6:33p, 7/14/20
Those shouldn't go towards Bexar county stats either if they are a resident of another city. I personally have not had a single Mexican National patient presenting for COVID. I know of one of my partners that had one, but this is not that common outside of border towns.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
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AgsMyDude
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In reply to Dr. Not Yet Dr. Ag • 6:55p, 7/14/20
AG
Only asking because you mentioned deaths. Does a positive test get routed back to county of origin? Assuming they were transported without a positive test or received one in Bexar county
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terradactylexpress
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In reply to Dr. Not Yet Dr. Ag • 6:59p, 7/14/20
Obviously that one has completely thrown the stats off

/s
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Dr. Not Yet Dr. Ag
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In reply to AgsMyDude • 7:02p, 7/14/20
It should if that information is available, meaning a patient or family member who can confirm county of residence.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
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