COVID-19 Update: Buckle Your Seatbelts!

The number of confirmed COVID-19 cases is surging, according to the latest data from the Virginia Department of Health. Confirmed cases reached 604 yesterday, a one-day increase of 164, the biggest yet. Meanwhile, the number of COVID-19 victims hospitalized increased to 83, also the biggest one-day increase yet seen in Virginia.

It is difficult to gauge how much the increase in the number of confirmed patients is due to actual spread of the disease and how much to increased availability of testing kits. The number of Virginians tested yesterday, 1,148, also set a record. The evidence I’ve seen suggests that the identified cases represent just the tip of the iceberg. Hundreds, if not thousands, of patients with COVID-19 symptoms are not being tested, due to a shortage of tests. In all likelihood, the epidemic has sunk much deeper roots in the population than indicated by the official numbers.

As the production and distribution of testing kits accelerates, a new bottleneck may emerge: a shortage of medical practitioners to administer the tests. Health professionals require training to give the test and they must wear personal protective gear when doing so. The training issue may be a short-lived problem, but the chronic shortage of protective clothing and equipment may be more difficult to solve as scarce supplies are allocated disproportionately to “hot spots” such as New York.

— JAB

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5 responses to “COVID-19 Update: Buckle Your Seatbelts!

  1. Here are John Butcher’s charts for total COVID-19 cases and new COVID-19 cases. The rate of increase is still logarithmic.

  2. Maryland is planning for the grisly possibility that the state will run out of ventilators and have to decide essentially who gets a ventilator and lives vs who doesn’t get a ventilator and probably dies. Gov Hogan has been smart enough to ask for non-governmental recommendations on this matter. Since there is no good (or analytically correct) answer it makes sense for the public to present an approach.

    https://www.baltimoresun.com/coronavirus/bs-hs-ventilator-surge-plan-20200327-dnguwrff7vcrfj3sg45negc3na-story.html

    • Ventilator shortage problem, if it comes to pass in life death situations, is very tricky, as well as fraught with ethical questions, and human emotion.

      For example, it will relate not only to who gets ventilator, but also for how long, as odds on ultimate survival typically decline substantially as one persons use and need for ventilators lengthens beyond several days into weeks. So who then gets to pull plug when survival odds are very low for one long term user, and very much higher for highly deserving patient next in line.

      At the other end of the equation, many people now have living wills containing do not resuscitate demand clauses in certain situations. When do these clauses apply in carona-vivus cases, and/or where other underlying preexisting conditions also apply. Many folks feel just as strongly about their right to die with dignity, as well as others who feel equally strongly about right to live at any and all cost. Lots of tangled up complications here.

  3. This is the tip of the iceberg. I know of one medical practice in Northern Virginia that is providing tests for patients of that practice. Whether the results of those tests are reported to DOH is not clear. I also know of one case in which a 21-year old recently returned from spring break in Florida and began having symptoms of covd-19. Because his symptoms were relatively mild, her doctor, assuming she had covd-19, elected not to test her, but told her to remain in isolation.

    Another factor hiding the true incidence is the longer response time for test results. In fact, people tested as much as ten days ago may not be reflected in the data. https://www.richmond.com/special-report/coronavirus/as-virus-testing-increases-in-virginia-some-results-are-taking/article_3842a9e7-2192-57fc-ae2e-234d2436a9be.html

  4. 63 cases in Arlington County or 1 case per 3,762 residents.

    231 cases in DC or 1 case per 3,055 residents.

    25,573 cases in NYC or 1 case per 328 residents.

    637 cases in Philadelphia or 1 case per 2,486 residents.

    88 cases in Baltimore or 1 case per 6,846 residents.

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