[MarkGoldberg]

Originally Posted by miharris

Several people have referenced an article in the WSJ regarding the coming surge of Covid-19 cases in the villages, so I decided to post a daily update on the surge. Since there is no separate reporting for the Villages specifically, I decided to combine the numbers from the 3 counties that include portions of the villages, as reported by the Daily Sun. It's not perfect, but its a pretty good representation of the overall trends in our part of central Florida.

As of today, we have 506 reported cases in Lake, Marion and Sumter county. Dividing by total deaths of 21 gives us a case fatality rate of 4.1%. That is higher that the state average of 3%, I assume in part due to the fact that Sumter county has the highest average age of any county in Florida, so a higher percentage of the population is at risk. On the other hand, it appears that the case fatality rate of new infections is much lower, possibly due to more widespread testing and better treatment.


Below is a breakdown of the trends.

New cases: 13, up 2.6% from the previous day
% infected: .058% of the population has been tested positive.
Total Fatalities: 21, there has been no change for the past 6 days.
% Fatalities: .00242% of the population in the tri-county area has died from C-19.

Odds you get infected: Based on the total number of cases, your odds of getting infected are 1,709 to 1. Based on the new infections, your odds are 66,538 to 1.

Odds you will die: Based on the total deaths of 21, your odds of dying from C-19 are about 41,190 to 1.

Again, those are based on total deaths. If you use yesterdays number of new cases as a baseline, and apply the 4.1% case fatality rate (observed), your odds of contacting the disease and dying from that infection are 1,632,075 to 1 on any given day in the Tri-county area. As a point of reference, the odds of getting hit by lightning in Florida are about 600,000 to 1.

In Sumter county, which may be a better proxy for the Villages, the observed case fatality rate is 6.7%, and new cases were up by 10 (6.1%) yesterday. Using the same math as above, your odds of contracting C-19 are 13,300 to 1 in Sumter county, and your odds of dying from the the disease are 198,507 to 1 on any given day, assuming 10 new cases per day. We'll see how tomorrow's numbers look, and I'll post an update then.

Stay safe and be reasonable.

Thanks for this clear picture. I look forward to seeing the numbers each day. Personally, I feel that May 25th we are going to see a spike after they begin to open things up on May 4th. People are going to act like overnight the switch was pulled and the pandemic cured. It’s not.

[Rsenholzi]

Not if you are one of the 21

[Shadia328]

Thank you, very interesting.

[Vstar3471@gmail.com]

Excellent information. Thank you

Some testing in California suggests 25 percent more people are infected than the infection rate suggests because they're not having symptoms and didn't get tested.

Great to see someone track this in the villages. Thanks for doing this!

[Eg_cruz]

I wonder when they are done testing the nursing homes and assisted living how that will change the numbers

[davem4616]

there's a covid-19 virus out there...it's still spreading...there is no vaccine as of yet...the risk to older folks is higher than to others, yeah, there's a lot of people anxious to get out and do the things that they used to do....

don't become obsessed with statistics, graphs and charts...just use your head, take control of your life back, and play it safe

[npwalters]

Originally Posted by MarkGoldberg

Thanks for this clear picture. I look forward to seeing the numbers each day. Personally, I feel that May 25th we are going to see a spike after they begin to open things up on May 4th. People are going to act like overnight the switch was pulled and the pandemic cured. It’s not.

It is reasonable to expect a small bump in numbers - not a spike - following business opening up. That is going to happen if we reopen next week or 2 months from now.

[MOMOH]

FROM MY FRIEND THE DOCTOR:
Is it safe to "open up" the economy?

Gregory Katz
Apr 22


I’ve been getting this question over and over again. Ending the lockdown is a constant topic of discussion. How do we make a decision about when it’s safe to restart our lives?

To start, my general impression is that the idea of “opening the economy” is something of a false premise. Yes, governmental restrictions play a role in what people do, but if people don’t feel safe going out in public, economic activity is only going to be a fraction of what it was before the pandemic. The individual choices that people for themselves make are going to determine our collective economic path forward more than any mandate from above.

I’m not going to pretend that I’m an expert on modeling the spread of infectious diseases or simulating the death rates without social distancing in place. I’m not an epidemiologist. This isn’t a post about how we model rates of infection and calculate an R0 for SARS-CoV-2 in order to estimate total deaths and intubated patients so that we can compare those numbers to the potential economic damage to guide our path forward.

How I think about the risk here

I’m a doctor. I know how to talk to my patients to help each individual personalize his or her own decision making. This is a post on how I would advise a patient of mine to think about their own personal choices - and those of their family members - with regards to getting back to normal life.

As a physician, it’s usually easy to tell people what to do. When it comes to most of the diseases I treat, I think about the data underlying different possible outcomes in order to make appropriate therapeutic decisions.

For example, a common medical problem I see is atrial fibrillation, an irregular heart beat that increases risk of stroke. To decide on the need for a blood thinner in these patients, I calculate the annual risk of stroke based on well validated data that is applicable to my patient. Once we have the numbers, our discussion can be personalized with an individual’s own approximate risk of a stroke and the approximate amount that a blood thinner reduces that risk.

Everyone has a different method of calculating their own personal risk/benefit analysis. But it’s a lot easier when you have some numbers to help estimate your own risk, even if those numbers are just approximations.

So what do the numbers look like in COVID-19?

The difficult thing with COVID is that we really don’t have the right type of information to help each person make his or her own decision (I’d argue we don’t have that information on a societal level to make policy determinations, but again, I’m not an epidemiologist).

Not to say that we don’t have data in COVID. We have approximate risk of death once someone is sick enough to come to medical attention, a number that is called the case fatality rate, or CFR. Depending on which dataset - and which population - you look at, the number ranges from about 0.3-3.5% (this being an average risk across age ranges, with higher risk in older folks and lower risk in younger ones).

When you think about it like those are the actual numbers, the risk/benefit calculation is straightforward, even if the resulting decision-making for each person may be difficult.

The problem is that we don’t really know how often people who get infected end up with symptoms of disease to warrant seeking medical care because we don’t have widespread testing across the asymptomatic population. If the overall prevalence of infection across our population is already 50%, it means that a lot fewer people who get infected are sick enough to warrant medical care than if only 5% of our population has been infected.

In some diseases, almost everyone who is infected gets sick. That doesn’t seem to be the case in COVID-19. So even if we know quite a bit about the CFR, we know very little about the infected fatality rate, termed the IFR (the number of people who die among all of those who are infected, not just among those sick enough to get tested).

I don’t envision a scenario in which I can have any type of coherent and personalized risk/benefit discussion with a patient when there’s this much of a range in possible risk. We are talking about a potential order of magnitude difference about how sick you might get.

Can you give me an example?

Let’s take a 70 year old man with no medical problems:

If the IFR is essentially identical to the CFR, our hypothetical patient is looking at an approximately 8% chance of death if he gets infected
But if the IFR is 1/10 the CFR - meaning that only 1 in 10 patients who are infected have a positive test results and become a “case,” that risk of death for our patient drops to approximately 0.8%.
That same 70 year old man coming into the hospital with a minor heart attack also has a risk of death of about 8%
Across society, the amount of morbidity and mortality even at a low range of estimates means an almost indescribable amount of pain and suffering. But for each individual trying to decide whether to go back to work, to go to the grocery store, or even to see family, this degree of variation could mean the difference between staying at home in isolation versus going about a quasi-normal life.

So what should I do?

The point of an exercise like this is that there isn’t a blanket recommendation for everyone. This is about understanding your personalized risk - a risk that’s reasonable for me might not be one that’s reasonable for you.

One person can look at a CFR of 8% and think, “there’s no way that I’ll go back to my regular life if there’s a 1 in 12 chance I die if I get infected. Why would take the chance of catching an infection that could be as deadly as a heart attack?”

But you might look at it and say, “I need to get back to the office and I need to see my family, so I’ll take my chances with a 92% likelihood of survival. Plus there’s a chance that the numbers are wrong and my likelihood of dying is much lower than that.”

The more clarity we have with our numbers, the more accurate we can feel about these estimates. As it stands now, there’s still a lot of uncertainty and all of the numbers above must be viewed with a grain of salt.

I’m hopeful that we will get to the point where we aren’t flying so blindly. But until we have more information, I am going to assume that the numbers are on the pessimistic side when I counsel my patients. It’s up to all of us to assess our own personal risk, and the better our testing is, the more comfortable we feel that we’re making those assessments based on reality instead of hope.

[Joanne19335]

Originally Posted by Velvet

Nothing new? What is the definition of “novel” virus? Dead are dead but the age range and the proportional number of the dead are very relevant to a retirement community.

When used in context with the coronavirus, the word “novel“ means new. It also means there is no cure. I suspect it will be one year to 18 months before there is a vaccine. Whether or not the villages reopens and we are back to “normal“, I will continue to do what I am doing now. I am not looking forward to a new rash of cases next fall when the flu season begins.

[bumpygreens]

MOMOH, how many of his patients expired while listening to the doctor's risk assessment?

[Jacob85]

No matter how you spin it this virus is very contagious and our population is very vulnerable. If we had more testing we would know the real story.

[JulieER]

Originally Posted by miharris

Several people have referenced an article in the WSJ regarding the coming surge of Covid-19 cases in the villages, so I decided to post a daily update on the surge. Since there is no separate reporting for the Villages specifically, I decided to combine the numbers from the 3 counties that include portions of the villages, as reported by the Daily Sun. It's not perfect, but its a pretty good representation of the overall trends in our part of central Florida.

As of today, we have 506 reported cases in Lake, Marion and Sumter county. Dividing by total deaths of 21 gives us a case fatality rate of 4.1%. That is higher that the state average of 3%, I assume in part due to the fact that Sumter county has the highest average age of any county in Florida, so a higher percentage of the population is at risk. On the other hand, it appears that the case fatality rate of new infections is much lower, possibly due to more widespread testing and better treatment.


Below is a breakdown of the trends.

New cases: 13, up 2.6% from the previous day
% infected: .058% of the population has been tested positive.
Total Fatalities: 21, there has been no change for the past 6 days.
% Fatalities: .00242% of the population in the tri-county area has died from C-19.

Odds you get infected: Based on the total number of cases, your odds of getting infected are 1,709 to 1. Based on the new infections, your odds are 66,538 to 1.

Odds you will die: Based on the total deaths of 21, your odds of dying from C-19 are about 41,190 to 1.

Again, those are based on total deaths. If you use yesterdays number of new cases as a baseline, and apply the 4.1% case fatality rate (observed), your odds of contacting the disease and dying from that infection are 1,632,075 to 1 on any given day in the Tri-county area. As a point of reference, the odds of getting hit by lightning in Florida are about 600,000 to 1.

In Sumter county, which may be a better proxy for the Villages, the observed case fatality rate is 6.7%, and new cases were up by 10 (6.1%) yesterday. Using the same math as above, your odds of contracting C-19 are 13,300 to 1 in Sumter county, and your odds of dying from the the disease are 198,507 to 1 on any given day, assuming 10 new cases per day. We'll see how tomorrow's numbers look, and I'll post an update then.

Stay safe and be reasonable.

I would say the odds are geared to healthy people. Add underlying conditions and odds won’t be as favorable for us oldsters.

[JulieER]

Originally Posted by vintageogauge

There are more than 900,000 people living in the three counties, TV is a small percentage of those people. 21 deaths out of 900,000 looks pretty good to me. I believe there are records of how many deaths in TV, last I read a few days ago was 9.

Not enough testing to really know how many there will eventually be. Community spread is unknown since 25% asymptomatic. And the new home testing kits are only about 82-87% accurate. I believe the death rate will go up over time as more and more people get infected unless we hold to social distancing and sanitize constantly.

[Golf2020]

Hannity Fox news last night and the Governor of Florida...”The Villagers have it right.” Social distancing....