Understand case, hospitalization, death, vaccine data
Understand case, hospitalization, death, vaccine data

Understand case, hospitalization, death, vaccine data

In the daily deluge of COVID-19 data, it can be hard to find answers to key questions: How bad is it, what to do about it, and when does it all end?

Data collection practices around COVID-19 have evolved, complicating their interpretation. And with these changes, we need to update how we understand the kind of numbers we have become all too familiar with. While the data comes with new reservations in the omicron era, they highlight a few important things:

  • Although no metric can answer all of our questions – each one is imperfect – they represent puzzle pieces that can be put together to inform personal decision-making and politics.

  • The circulation of COVID-19 in communities and hospitals is only part of the risk calculation for individuals; data have consistently shown that vaccination reduces the risk of infection, hospitalization and death.

  • Daily COVID-19 data do not provide clear answers as to what going back to “normal” looks like, how we can get there, and when it will be. But that uncertainty does not change the ultimate goal: to reduce the number of deaths and hospitalization.

Cases and hospitalizations still indicate the status and urgency of the pandemic, but interpreting them today presents new challenges. Here are some things to note about what the data can not tell you.

Cases do not fully capture Community transmission. At the beginning of the pandemic, with limited testing, reported cases did not fully capture the spread of the virus. Two years later, testing is much more widespread – but with a new version of the same problem.

The United States has made home testing far more accessible. The catch? The results of these home tests are not included in the reported case numbers. It’s just unknown how much the numbers underscore reality, but the problem is likely to grow with the rise in home tests.

There are other ways to measure community transmission. Methods that are “passive,” or that do not rely on people reporting results, can fill some gaps, said George Anesi, a Penn professor of medicine.

Such a method there CDC user measures COVID-19 levels in wastewater. Wastewater data can independently confirm trends seen in reported cases and serve as an early warning signal before reported cases start, although the data should be interpreted with caution.

Hospitalizations may reflect increased transmission, not necessarily severity. Given the uncertainty with case numbers, it is tempting to look at admissions because virtually everyone who is admitted to a hospital is tested for COVID-19.

However, these hospitalization numbers may indicate an inflated picture of the number of serious COVID-19 cases.

The data do not distinguish between people who are hospitalized because of COVID-19 from those who are hospitalized and happen to test positive for it. For example, “random positives” accounted for more than 60% of COVID-positive patients in the Jefferson Health system in January.

Still while the virus may not be the cause of a hospitalization, it can aggravate or complicate other conditions. So it is difficult to distinguish between random positive and serious outcomes. In both cases, the number of admissions still reflects the burden on the hospital.

Although omicron is less likely to cause serious illness requiring hospitalization, especially among those vaccinated, hospitals were overrun because so many people got it. And each COVID-positive patient increases the risk of staff exposure and takes up valuable bed space.

Do not look at numbers at the population level to keep track of the vaccine’s effectiveness or the effects of new variants. Partly due to the clutter of the data, population-level figures are not ideal for understanding how the effectiveness of the vaccine changes over time, especially as new variants emerge.

Too much of that analysis is dependent on the United States in other countries that have better data reporting systems, often with national health systems, said Michael LeVasseur, professor of epidemiology and biostatistics at the Drexels School of Public Health. “Our data in the US is so siloed, and it’s so hidden behind all sorts of barriers, that it’s really hard to draw a big picture.”

Everyone’s risk is different, based on factors such as age, health history and vaccination status.

In addition to personal risk, consider the societal consequences of possibly spreading a disease that puts the most vulnerable at risk.

But while it may sound scary, interventions to reduce COVID-19 risk remain unchanged: “Wear a mask, stay home if you are sick, wash your hands, social distancing,” LeVasseur said. And most effective of all: vaccination.

Here are some guiding principles that experts agree on.

Get vaccinated but know it is not bulletproof. Vaccines remain effective in preventing serious illness and hospitalization. And booster shots help protect people from the worst results, especially those who are older.

It is important to remember that vaccines do not make you invincible. They reduce the relative risk of getting the virus. When societal transmission is high – which increases the basic level of risk – even very effective vaccines can not completely eliminate the risk. Vaccines work best when we reduce the amount of work they have to do as much as possible.

Public health experts recommend a multilayer approach: measures such as getting vaccinated, wearing masks and social distancing do not replace each other but can be used together to maximize individual and local protection.

Add layers of protection as the risk increases. Deciding exactly how careful to be – especially when socializing – is challenging. Data show that the virus is often transmitted in social contexts. In addition to limiting interactions, people have other tools at their disposal: quick testing, masking, increased ventilation, and gathering outdoors when the weather gets warmer. The CDC has a county case rate threshold, in addition to which it recommends indoor masking.

Anesthesia recommends paying attention to both the number of reported cases and how they change, saying “lanes can be very, very helpful.” Both still have shortcomings: Reported figures are difficult to compare over time due to how tests have changed, and trajectories do not take into account the level of societal dispersal at any given time.

For example, in February 2022 with omicron on the decline after a rapid peak, “we are still at a much higher level than we have been at [during] other points in the pandemic, ”he said.

Data often lags, so be proactive. Data represents a picture of the past, even when reporting systems work perfectly. Test results can take days to identify cases. The number of admissions increases after the case because the virus takes time to cause serious illness. And deaths lags even further back.

Reporting delays can create a false sense of security in people trying to understand COVID-19 at the moment. Whatever the daily numbers show, the virus rewards being proactive.

“I do not want people to use a dashboard as a weather forecast,” LeVasseur said. People should take precautions without waiting for the numbers to rise, but these precautions become even more necessary when transmission is high.

The data can provide glimpses into the status of the pandemic and indications of how individuals and policy makers should respond. But do not focus on cases, hospitalizations or deaths to know when it all ends.

Public health officials generally agree that the eradication of COVID-19 is off the table.

Of course, there is a mathematical definition of when a pandemic becomes endemic instead, like the flu. But it will not tell you when you do not have to think so much about COVID-19. Technically, the virus is considered endemic when each infected person continues to infect around one other person. In practice, even the flu has not reached that definition, as it can spread quickly depending on the season.

What people actually want to know is what our collective victims are trying to achieve and when they may no longer be needed. The answer to that question is unchanged from March 2020, LeVasseur said: avoid overcoming the health care system.

We want hospitals to be able to take care of all patients. The goal is that most people worldwide only become infected after being vaccinated – save their lives and a trip to the hospital.

We want to “prevent our hospital system from becoming overburdened” by not having enough staff, beds and other resources, LeVasseur said. “No one has moved the goalposts.”

The full number of the pandemic goes beyond daily numbers. A big concern for experts is how hospital load led to cancellation or postponement of so-called elective surgeries. The are not necessarily optional procedures; many are essential. They are often only optional, as they do not have to happen right away, but postponement over a long period of time can still cost lives.

COVID-19 cases and deaths also do not cover the costs of mental health, educational equality, social mobility or housing and food security that people have borne for two years. These damages will resonate for generations. Pandemic recovery defined more broadly will be a years-long effort – no matter what the numbers say today.

Leave a Reply

Your email address will not be published.