A COVID Update Before the Winter Surge

by Carol J. Bova

As the election furor dies down, interest will turn to the expected winter surge in COVID-19 cases. Before we get caught up in the onslaught of dire predictions in the news and resultant handwringing over national and worldwide numbers, let’s look at Virginia’s numbers.

From October 3 to November 3, there have been just under 34,000 diagnosed cases of COVID-19 ,with 1,576 hospitalizations and 404 deaths as seen in the chart above.

Long-term care facilities had 52 outbreaks between during that period with 1,666 cases and 174 deaths.

Where are the reports on what VDH is doing about infection control at nursing homes or Department of Social Services at assisted living facilities? Is anything being done, or are there inadequate numbers of staff to cope with the need? How much of the CARES funding has been directed to these efforts?

Although not as dramatic as outbreaks in long-term care facilities, correctional facilities had 10 outbreaks with 845 new cases and 8 deaths in the past month. If news reports are accurate, these outbreaks are too often the result of failing to isolate and test new arrivals before introducing them into the general population, failing to isolate those who become ill, and failing to supply adequate handwashing supplies and masks.

Virginia Numbers Since the Pandemic Began

Of 185,836 cases in Virginia since the pandemic began, this is the breakdown by age group:

  • Ages 0-19 had 13.9% of all cases and 1.9% of hospitalizations.
  • Ages 20-39 had 37.4% of cases and 12.5% of hospitalizations.
  • Ages 40-59 had 29.1% of cases and 30.7% of hospitalizations.
  • Over age 60 had 18.7% of cases and 54.8% of hospitalizations.

Ages 0-19 deaths were 0.03 percent (one teen-age death).

Ages 20-39 deaths were 1.3% of the total.

Ages 40-59 deaths were 9.4%.

Deaths for those over age 60 made up 89%.

Public health measures should focus on the number of serious illnesses requiring hospitalization and deaths. So, besides better control of infection outbreaks in closed settings, we might ask where are the public health campaigns to address factors such as obesity, hypertension, diabetes, and Vitamin D deficiency that can lead to serious COVID-19 illness? Such campaigns would improve public health in general, even for citizens who do not get the virus.

Track and Trace Efforts Need More Testing

Testing in Virginia has not been adequate to define the extent of community spread as it occurs. RAND Corporation has said a number of times in their weekly reports that 5% testing positivity is a target for a successful test-and-trace policy.

Every time the positivity number went over 5%, it wasn’t necessarily an indicator that people weren’t following mitigations, as the Governor implied in press conferences. It was just as likely those with the virus were exposed and infected by people close to them who were asymptomatic, pre-symptomatic or so mildly ill they didn’t recognize it as COVID-19 and were not identified by testing. Total case numbers are not the issue. If test and trace is the policy, then more testing needs to be available where needed whenever positivity spikes.

There’s no need to hobble the economy by lockdowns. More openness about events causing small spikes in communities would be of more help. A weekly report, not necessarily by community, but by type of event, might keep people alert to the risks of gatherings like weddings, funerals, religious attendance, or family celebrations.

Now is the time to act where we can to inform citizens and for state agencies to redouble efforts to control institutional outbreaks, not after the surge blows up in the reports and causes panic responses.

Carol J. Bova is a writer living in Mathews County.


Note on methodology: The Virginia Hospital and Healthcare Association (VHHA) reported 2,688 cases during this time. The number differs from the that of Virginia Department of Health (VDH), which counts only those hospitalized at the time VDH is first notified. If someone enters the hospital after that first report, VDH does not track it. Because VHHA does not report by age group, I have used the hospitalization numbers based on VDH reports.

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16 responses to “A COVID Update Before the Winter Surge

  1. “Every time the positivity number went over 5%, it wasn’t necessarily an indicator that people weren’t following mitigations, as the Governor implied in press conferences.”

    Yes … that is what the dipstick implies. His solution to the second surge is for people to wear masks, socially distance and wash their hands regularly. That’s it. In other words, do what has already been done. That’s all he has to offer. Of course, one day Northam will wake up and declare a disaster. He’ll forbid indoor dining, close gyms, close schools. Who knows what else. Why? Because the clod is more interested in court cases about removing a statue of Robert E Lee than the health of Virginians.

    • Nope. Only SW Virginia is showing much of an increase. Eastern, Northern and Central Virginia have been surprisingly stable, tiny upticks, as other parts of the US clearly are really spiking again. Northam is right not to panic at this point and I’m not sure why you are so eager to.

      I do agree that Northam and his team are too quiet, not communicating enough. They suck at that. Badly. I assume they have info on where these new cases are appearing, and if it seemed that restaurants, gyms, etc were the issue they’d do something. I’ve heard of no cases at our Y, and we’ve been going now for more than four months. I’m hearing it is the gatherings you usually hear about, mainly social events, public and private. Plus the congregate settings Carol wrote about.

      I’ll be a good test. 🙂 Almost 15 hours at the polling place, protected only by a mask and the occasional spritz of sanitizer or hand soap, touching voting slips handled by probably 750 folks coming in….They say I should wait 5 days to feel clear…tried the gloves but it was hard to be sure I was handing over only one ballot, not two. I was worried there would be folks hacking and coughing, but didn’t notice any. I didn’t see anybody not wearing a mask in the room, which surprised me. Most were in front of me for five seconds or less, but perhaps five or six times somebody had to fill out the voting assistance form and in those cases I usually leaned in to help.

      • Not sure where you are getting your data.

        https://www.restonnow.com/2020/11/02/fairfax-county-sees-continued-covid-19-rise-as-virginia-hits-new-high/

        “Virginia’s northern region as a whole saw a steady upward trend in cases throughout October, but it has become more pronounced over the past week, when the region’s seven-day moving average rose from 234.3 cases on Oct. 25 to 322.3 cases today.”

        • https://www.vdh.virginia.gov/coronavirus/coronavirus/covid-19-in-virginia-cases/

          I look at the subset “Northern” and I see the most recent 7-day average of about 260 as of a week or so ago, not that far off where it peaked in August. If it has passed 320, not showing on this chart. Even if it has, not the big spike you are seeing elsewhere, the “hair on fire” numbers the networks were screaming about daily in the Beat Trump Campaign.

          • DJ and Steve: You’re not using the same data or dates.
            Steve, your link is to number of cases by date of symptom onset, which doesn’t include the last 3 days, and VDH changes the numbers as they identify more cases with previous onset dates. DJ, the paper is using cases reported at https://www.vdh.virginia.gov/coronavirus/key-measures/ by day as of November 2nd when the rolling average was 322.1. Today’s report shows 304.

            I gave up trying to keep stats on the rolling average by symptom onset a while ago. Every week, the UVA model reports are still changing days to detection from April and May!

            What I do when I want to be sure I’ve got the best available numbers by locality and district is pull the dataset for cases by locality, count back 7 days and use that number. Then sort by region if I want that number.

            For the 7 calendar days ending 11/4, VDH reported 9019 total cases. The previous 7 days totaled 8079.
            As of 11/4 (day VDH recorded the cases, not the website report date), the region 7 day averages are:
            Southwest 417.9/day.
            Northern Region averaged 304.1 per day
            Central 198.4
            Eastern 195.4
            Northwest 172.6

            We won’t know if this is just a temporary spike or a longer term surge for a couple more weeks.

    • “In other words, do what has already been done.”

      Masks are tyranny. Haven’t you heard? I just spent 10 days kicked back on a beach in a State where the residents are clearly suicidal. We went out for dinner exactly 3 times, twice to the same location because the tables were set far apart and partitioned on 3 sides. The staff wore masks.

      • When I go to Destin I try to spend as much time as possible on Danny Wuerffel Drive. That kind of karma is fool-proof.

        • Not familiar with it. Is it one of those wonderful roads where the 3-way intersections have lights that only stop the left lane while allowing x-traffic to turn onto th highway? I love those.

          Two kinds of drivers in Florida. Those in diesel dualies at 100MPH, and those who park their caddy in the bus stop. Cowboys (crackers in fla) and those waiting for god.

      • Masks are not tyranny. Judge Cavedo is not a racist. Daniel Gade is not a U.S. Senator….Hey, running statewide as your first attempt, with nobody giving you any chance or any real money, he was in an uphill battle from the start. Mark not John took his lumps first time out.

        • He ran as a Republican in the age of Trump. He could be batshit crazy and was guaranteed 40%. It’s like the VT football team and their 400 SAT score. (If I recall they scored the fill-in name block on the math and verbal at 200 points each)

  2. https://www.npr.org/sections/health-shots/2020/11/05/917317541/clots-strokes-and-rashes-is-covid-19-a-disease-of-the-blood-vessels

    Whether it’s strange rashes on the toes or blood clots in the brain, the widespread ravages of COVID-19 have increasingly led researchers to focus on how the novel coronavirus sabotages the body’s blood vessels.

    As scientists have come to know the disease better, they have homed in on the vascular system — the body’s network of arteries, veins and capillaries, stretching more than 60,000 miles — to understand this wide-ranging disease and to find treatments that can stymie its most pernicious effects.

    • Some of the monoclonal antibody work is aimed at preventing or controlling the inflammatory processes tied into the autoimmune reactions that cause the vascular effects. As an example: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7438984/

      Not everyone experiences these vascular effects. A friend had it early in the spring before there was as much info as we have now. He developed pulmonary embolisms that were treated with standard anticoagulant treatment and survived to go back to a normal life after a rough week in ICU. Another friend’s father didn’t survive a weekend.

      Another study sums it up: “COVID-19 disease mostly affects middle-aged and elderly patients. Children seem to be asymptomatic or get a mild form of the disease…. A higher risk of infection has been noticed in older patients, male sex, patients with medical comorbidities, patients with chronic pulmonary or chronic cardiac or chronic kidney disease, and patients with diabetes.” https://www.ncbi.nlm.nih.gov/books/NBK556152/

      • Yeah, and this makes it a different animal. They have also noted a difference in blood types to severity.

        Steve calls it “fear porn” but given what we know about viruses in general and what we don’t know about this one, I would not be so cavalier about the infection of our children simply because they “appear” to be immune to ill effects.

  3. Study carefully Carol Buva’s above chart to see the real impact of Covid-19 on Virginia’s children. What a breath of fresh air!

    Carol BR posts on Covid – 19 serve wonderfully to erase the false information put out by crony politicians and phony scholarship by UVA professors writing propaganda to scare and undermine kids, instead of providing us all with the truth of what is going on in the real world.

    I rank BR’s Carol’s reporting right up there in the rarefied air of Holman W. Jenkins Jr. for truth telling perspectives on complicated subjects.

    For example:

    Here is a sampling of Holman Jenkins’ Oct. 30, 2020 Wall Street Journal article titled:

    “The Other Media Blackout, How can American’s use good sense about an Epidemic When they are Fed False Information.

    … On Thursday, the Hindustan Times noted in its headline a 40% positive antibody rate from the latest survey of the Srinagar district. Only far down in the story did it indicate this was 25 times the “confirmed” case count.

    Why can’t our press do the same? In the U.S., the reality principle is not blacked out only if you look hard enough. A New Jersey survey in August found 14.7% of the population infected, seven times the confirmed cases. A New York survey in late March suggested two million infections; the official count was 76,000. An Orange County, Calif., survey in August found true infections seven times the official case count. A national survey of dialysis patients in July showed a similar ratio. I could go on.

    Any single study might be flawed, but the findings are echoed in every country. Maybe our press imagines that our testing is so voluminous and efficient that it now is converging with the underlying infection rate. Wrong. Voluntary testing is inherently biased. Last month, a U.K. study should have put a stake in any delusions on this point. Relying on random, rather than patient-initiated, testing, the report estimated that daily new infections were running about nine times the official rate as of late September.

    Nearly half of Covid infections are believed to be asymptomatic. From previous research, 80% of people with flu symptoms and 95% with cold symptoms don’t seek medical help. Though 150 million total tests given in the U.S. so far, and 1.2 million new tests a day, sounds like a lot, it’s not when 330 million Americans can be negative one day and infected the next.

    Unfortunately, because our press wasn’t in Mr. Stuppy’s science class, it doesn’t understand that while confirmed cases might be data, they aren’t a sample in any meaningful scientific sense.

    Not to be dramatic, but when I refer to a conspiracy of silence, I really mean a mosaic of misrepresentation required by a certain mood. Our press this week reported, with hair on fire, that confirmed cases exceeded nine million. Would its hair be more aflame or less if it acknowledged true cumulative infections are likely between 50 million and 100 million?

    A realistic picture would suggest tens of millions of Americans have encountered the virus without fuss. It would suggest the death risk for any individual is flu-like—as Dr. Anthony Fauci, the Oxford Centre for Evidence-Based Medicine, and many other experts have been telling us since February.

    The bigger numbers might suggest we are grappling with a natural phenomenon over which we exercise little control.

    Let’s recap. Unlike the flu, 160 million of us of aren’t vaccinated against the new virus. None of us, school age and up, have resistance from previous encounters. Local hospitals face a Covid challenge two or three times bigger than their annual flu challenge simply because so many more of us are susceptible. Plus there’s the non-negligible risk of a severe reaction when our immune system encounters a virus it hasn’t encountered before.

    All of us would rather not get the disease. All of us benefit from putting it off until hospitals learn how to treat it—even though the risk for each of us is flu-like

    But the reality principle doesn’t ignore us even if we ignore it. The test-and-trace silver bullet, which epidemiologists once promoted, Dr. Fauci now admits is impractical because of a large number of asymptomatic cases. Germany, once a role model, admits it has been able to trace only 25% of confirmed cases, which probably means 5% of true cases.

    Our politicians have had to become realistic about withholding their interventions unless and until hospitals become overwhelmed. For many of us, especially the young, it makes no sense to impoverish our lives to suppress Covid.

    When Joe Biden calls this running up the white flag, he’s prepping you to believe that Donald Trump could have stopped Covid and now a President Biden is stuck with a mess. Whoever is president next year will need to introduce more realism than this into the discussion as a vaccine rolls out.

    Once again India is ahead of us: Its Business Standard newspaper jauntily warned its upscale readers that they can expect to be screened out because “the government does not wish to waste the precious vaccine shots” on millions who already have antibodies the natural way.” End Quote

    For more see: https://www.wsj.com/articles/the-other-media-blackout-11604094677

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