Category Archives: Case Update

Case Update: May 2nd, Video: Simulating an Epidemic

All Articles, Case Update, Communication, Video

The number of news cases has been erratic in the last week, but at least in the US, it continues to trend downward. I’ve started collecting the number of new cases in the US and California, and while I’m not sure how to integrate that data into my Excel spreadsheet yet, I can tell you that more tests definitely mean more new confirmed cases. So some of the erratic graphs were seen are definitely because of more testing. In the long run, I expect to see new cases come down drastically as we continue to increase testing.

Rt.live is showing that 45 of 50 states have an Rt value below 1 yesterday. This is great news, as it shows that in most states, the virus is slowly disappearing. I’m watching with great interest to see how the states that have started re-opening do. Keep up the great work! We are having an impact!

Also included is a very interesting video I ran across, Simulating an Epidemic, showing a non-scientific computer model of possible epidemic outcomes given different approaches. Keep in mind, this model is NOT attempting to show what will happen in the COVID epidemic, just some theoretical things that might happen given different approaches. He does NOT attempt to prove that any of these things are what’s happening.

The most interesting parts for me were when he compared 2 methods that have been used in different places. At 6:00 minutes, he talks about the Detect and Isolate method, which I favor. This is were you find an infected person and quickly quarantine them until they have recovered. He argues that this is the most effective method in an epidemic like the current one. We haven’t been able to do this, really, because of our lack of testing in the beginning. My fervent hope is that if we get a second wave in the Fall or Winter, we will be ready for this approach.

At 16:50, he talks about a method that I think we are kind of using, the shelter in place, but with trips to central locations. He says that without other measures, these locations become a source of new infections. This is probably not happening as badly in real life because so many are wearing masks to the store!

Don’t fear, but be smart!

Erik

Case Update: April 27th

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Originally posted on April 27th, 2020 on Facebook

Friends,
On April 22nd, I showed you data with a big increase in cases from the previous few days. Several outlets have confirmed that increased testing is leading to this apparent big increase in cases. The Johns Hopkins site that I get my data from has started releasing testing numbers as well, but I haven’t been collecting those. I’m going to start, but it will be awhile until I can meaningfully integrate that information. Labs often release reports in big batches, so this makes the graphs like mine look erratic. For the US, California, and San Diego County, there is an apparent increase in cases for the last week or so. Much of this is because of increased testing. As testing catches up to real cases, we’ll know better what our real case load is.

Some good news is that the site I introduced on April 20th, rt.live, has made some revisions to their model. They claim they’ve corrected for the increase in testing, and now most states are seeing a nice downward trend, and all but 7 have an Rt value below 1. This means that each infected person is passing the virus on to less that 1 other person, so the virus is slowly going away in that state! That is great news! This will also impact what states can move into the 1st reopening phase.

A doctor friend of mine says that the number of deaths per day is perhaps the most reliable way to tell for certain that the virus is receding, because this number is not confounded by the number of tests being given. This is certainly true. Unfortunately, deaths sometimes occur weeks after infection, so it takes a long time to see the impact of a change in behavior if we wait for the number of deaths to inform us. So no number is perfect. Also, there has been controversy about how deaths are reported. Some cases of COVID have been confused for flu or other pneumonia and vice versa. Only the reporting physician may know all the factors going into that decision, so we often can’t figure this out by looking at the numbers.

Our efforts are having big impact, and several states will start reopening today! We can certainly hope they will be successful.

Don’t fear, but be smart!
Erik

Rt Live

Case Update: April 9, When can we go back to normal?

All Articles, Case Update, Re-opening

Originally posted April 9th, 2020 on Facebook

Friends,
You may have heard lots of positive news in the press in the last few days about new lower rates of new infections in the US. If you saw my posts on March 30th and April 1st, you know that I was enthusiastic about some good news a little earlier than was warranted. So I wanted to wait a few days to see if the current positive trends would hold.

All that being said, I do have good news for you today! For the World, the US, California, and San Diego County, the rate of new cases as been below 10% every day since Sunday, April 5th! That’s great news. The actual daily new cases has been trending basically flat in the US since Sunday, and in California since April 1st. So the news is definitely good! There is even better news if you live in San Diego County. Daily new cases actually appear to have peaked on April 3rd, and are actually down since then.

Some in the media are discussing an end to our isolation, but I have to say that it is still very important that we continue to practice social distancing for a while longer. Our efforts are working, but we still have a lot of work to do!

My brother asked me when I thought it would be safe to go back to normal. I’ll preface my opinion by saying that I am not an epidemiologist. My opinion on this is informed, but I’m not an expert. In my opinion, we can go back to normal when:

  1. Our daily new cases are very low, a few a day.
  2. We can be reasonably certain that we know where every sick person is located, and that they are isolated.
  3. That we have enough testing capacity that we can test those who have been potentially exposed, not just confirming cases that appear to be COVID-19 cases by symptoms.

You can see that we have quite a ways to go to achieve these 3 criteria. So it’s important that we remain diligent! It is highly likely that we will experience a second wave of infections if we try to go back to normal too early.

A local physician told me last week, April 1st that wait times for testing was 12 days. Yesterday, Wednesday, April 8th, he said that results were coming back in just 2 days. So with new cases falling, we are able to test much faster. This will eventually give us capacity to test for exposure! I don’t know if public health officials are considering this yet.

So be encouraged, but be diligent! Your efforts are paying off!

Don’t fear, but be smart!
Erik

Are We Flattening the Curve?

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Originally posted April 3rd, 2020 on Facebook

Friends,

Is our isolation helping? In mid-March, the rate of increase of new confirmed cases was around 40%. Yesterday it was around 15%. I made this graph of what the case load in the U.S. MIGHT have been if we were not in our homes.

It may seem like you’re wasting your time, but you are helping! Many people AREN’T sick today because of our efforts. So keep it up!

Don’t fear, but be smart,
Erik

Case Update: April 1st

All Articles, Case Update, Treatments

Originally posted April 1st, 2020

Friends,
I have to moderate my enthusiastic post from a few days ago some good news/bad news information. The good news is, for both the US and California, the rate of new cases is still trending down and is now below 20% for both regions. Unfortunately, even with the lower rate, the total number of new cases is still increasing after a short pause. It is definitely increasing at a slower rate, and that’s good, but increasing nonetheless.

Some have asked, how are these number affected by the new testing? It’s hard to say. The US is definitely doing more testing, and bringing more on line all the time, but our testing is still not adequate to capture all the information we need. There are still certainly a lot of cases we don’t know about, especially among asymptomatic and pre-symptomatic people. So even if you don’t have symptoms, it’s still important to keep your distance from others.

Others have asked about the new drug treatments that President has been enthusiastic about. Keep in mind that the medical field is highly regulated, and scientists and regulators are very slow to say a piece of equipment, test, or drug works until rigorous testing has been completed. So is the President right in saying these new drugs show promise, or is Dr. Fauci right in saying we don’t know yet. Well, they both are. The President is being hopeful, citing trials by physicians in other countries and in the US, and Dr. Fauci is expressing caution that the drugs have not been rigorously tested. Both things are true. The FDA recently approved the use of these drugs in trials here, and physicians in the US are always allowed by their credentials to use drugs off label. So testing is being done, and hopefully, we’ll have something that can be used widely soon.

Stay safe, my friends!
Erik

Case Update: March 30th

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Originally posted March 30th, 2020

Friends!
Lots of good news today! The trend of lower rate of new infections has continued for the US. In fact, yesterday March 29th, we had fewer new cases than the day before. I’m hopeful that this trend will continue and we are finally on the way out of this.

Good news for my home state of California as well! We’ve actually had fewer new cases each day for the last 3 days!

What this all says is that the social distancing we’ve all been doing is working, and we are finally starting to get control of the virus. Your sacrifice is paying off!

What I’m hoping and praying for next is that this trend will continue, and that we will be able to start testing for exposure, not just testing those who already appear to have COVID-19 symptoms. Then we’ll really start to have a better idea how the virus is spreading.

So keep up the great work!

Don’t fear, but be smart!
Erik

Rate of New Cases Down, US Confirmed Cases Surpass China’s

All Articles, Case Update, Risk Factors

Originally posted March 28th, 2020

Good morning, Friends,
It’s good and bad news this morning. The good news is, our recent trend of a reduction in the rate of new cases in the US is holding! We’ve gone from being consistently in the 40% range, to consistently in the 20% range. This is good, but the bad news is, because our numbers are getting high, a lower daily percentage of new cases still means an increase in daily cases. Plus, in California, where many of you live, the rate has not trended down.

Unfortunately, the US now has more confirmed cases than any other country, surpassing China on Thursday.

So we doing better, but we need to to better still. The numbers are impacted by several things of course, one being our much improved testing rate. This certainly drives the numbers up, but I’m cautiously optimistic that the lock-down many you are experiencing will lead to big improvements soon. So keep it up! Your efforts are not in vain!

A few days ago, I mentioned that those with auto-immune disorders (like me) may be at higher risk. I still have not found an authoritative source for this. Since then, several news organizations have posted reports of people doing worse if they had taken non-steroidal anti-inflammatories (NSAIDs), including ibuprofen. Since auto-immune sufferers often take these medications, this may be part of the reason for their higher risk. This information is evolving, and will likely continue to change for awhile. Myself, I have quit taking one of my anti-inflammatory medications. Check with your doctor before you stop taking a prescription!

Don’t fear, but be smart!
Erik

PS If you’re wondering why testing in the US was so slow to get rolling, check out yesterday’s post.

10 Fold Increase

All Articles, Case Update

Originally posted March 25th, 2020 on Facebook

As I feared, the case load in the United States has gone by 10 fold approximately every week. When I first gave my talk on March 3, it was 124. On March 13 for Mars Hill, it was 1,762. As I write this on March 25th, it’s 55,041. By Friday the 27th, if the current rate holds, it will be approximately 150,000.

There is some good news, however! In much of the US last week, containment measures have been taken and many are in their homes right now for this reason, working from home, or just taking some time off. It has been a big sacrifice for everyone, and the sacrifice isn’t over. While new cases are still rising, the rate of new cases is starting to go down! For the US as a whole, the rate of increase was between 35-40 between the 17th and 22nd. For the last several days however, the rate has been 31%. Yesterday, the rate fell to 19%! This is still too high of course, but our sacrifice is beginning to pay off. So keep it up!

The curve for the total number of cases is just beginning to bend. It’s just a beginning, but it’s progress. The more we bend this curve, the more lives we save!

Don’t fear, but be smart!
Erik

As I feared, the case load in the United States has gone by 10 fold approximately every week. When I first gave my talk on March 3, it was 124. On March 13 for Mars Hill, it was 1,762. As I write this on March 25th, it’s 55,041. By Friday the 27th, if the current rate holds, it will be approximately 150,000.

There is some good news, however! In much of the US last week, containment measures have been taken and many are in their homes right now for this reason, working from home, or just taking some time off. It has been a big sacrifice for everyone, and the sacrifice isn’t over. While new cases are still rising, the rate of new cases is starting to go down! For the US as a whole, the rate of increase was between 35-40 between the 17th and 22nd. For the last several days however, the rate has been 31%. Yesterday, the rate fell to 19%! This is still too high of course, but our sacrifice is beginning to pay off. So keep it up!

The curve for the total number of cases is just beginning to bend. It’s just a beginning, but it’s progress. The more we bend this curve, the more lives we save!

Don’t fear, but be smart!
Erik

Asymptomatic Transmission

All Articles, Case Update, Communication, Risk Factors

Originally posted March 22nd, 2020 on Facebook

I know I’m not exactly Mr. Fun these days, but I have another little update. According to March 16th paper in Science, one of the worlds 2 leading scientific journals, asymptomatic people who are infected with the SARS-2 virus are about half as contagious as sick people. However, because there are so many of them, asymptomatic people account for 80% of new infections! (Li et al, Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV2), March 16, 2020, Science Magazine).

The take away is, yes, even if you are not sick, you can spread the virus! So please stay home, and protect your neighbors!

Update on cases, California on lockdown, auto-immune disorders

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Originally posted March 21, 2020 on Facebook

Friends,

Just a little up date from last week’s talk. I mentioned in the talk that I saw a 10 fold increase in cases since I gave my first talk to a small audience on March 3rd. The US had 125 cases on the 3rd, and 1762 cases on the evening of March 12th. This morning, March 21st, the US has 19,931 cases, another 10 fold increase since my talk last week! Some of this is because of increased testing, but there are certainly many, many cases we don’t know about yet.

The caseload has been going up consistently by about 34% more each DAY in the US, 6000 new cases just yesterday March 20th. We NEED to get the rate of new increases to come down. Increased social distancing measures will help, but because of the long incubation time, it may take a few days or weeks to see a benefit.

Autoimmune disease: There have been recent reports, that those with autoimmune diseases (like me) are at special risk because our immune systems are already overactive, and will do extra damage to our bodies while trying to combat the SARS-2 virus. In a brief search online, I have not been able to find confirmation of this report. If you have Celiac Disease, MS, some kinds of Diabetes, or other autoimmune disease, take special care.

My state, California, has instituted a voluntary ban on non-essential outing from your house, except for:

Getting food
Care for a relative or friend
Get necessary health care
Go to an essential job

If your job is essential, you know it by now!

Going for a walk is still a good idea if you keep a safe distance (at least 6 feet) from neighbors.

Also, consider texting neighbors, or using Nextdoor or a similar site to try to find people in your area who maybe do not have social connections and may need extra assistance, like food and supply delivery. Ding dong ditch!

I also heard a good idea about buying gift cards from your favorite stores in town to support them until things get back to normal.

That’s all for now! Take care!

Don’t fear, but be smart!
Erik