07/11/2020
From HealthTap a health technology company. It gives insight into understanding some of the data emerging from the worsening of the pandemic burden in the United States.
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What will happen to the death rate as the epidemic surges?
While the U.S. is in the throes of a worsening coronavirus epidemic — single-day new cases are regularly breaking prior records — the situation is quite variable at the state level, and even more so at the county level. The northeast states largely have the epidemic under control, whereas the southern and western states are seeing surging case rates. Three of the hardest hit states — Arizona, Florida, and Texas — are experiencing dramatic rises in case rates, and during this past week, rising death rates. Their healthcare systems are increasingly strained, as demonstrated by rising ICU bed usage:
* Arizona had 89% of ICU beds in use as of Thursday[1].
* Florida had 85% of adult ICU beds in use as of Friday[2].
* Southeast Texas had 81% of current ICU beds in use as of Friday (this is 96% of ICU beds that were available until additional ICU capacity was added)[3].
* All of Texas had 944 ICU beds remaining available as of Friday[4], suggesting approximately 86% of Texas's 6,663 ICU beds[5] are in use.
The overall case fatality rate is falling, largely due to the younger average age of the recent new cases, and treatments such as corticosteroids (dexamethasone) and remdesivir. Given what we know about the disease, it is likely that we are on a path to continued rise in the death rate, which is a lagging indicator of this disease.
Some have taken the recent decreasing death rate to promote the idea that the COVID-19 crisis is over, despite clear rises in case rates. It is disheartening to see how COVID deniers use these trends to undermine the efforts of physicians, epidemiologists, and other experts who are warning of the danger, especially to those at the greatest risks from COVID-19. It is important that we, as physicians, do everything we can to spread good information and prevent the spread of alternative narratives.
It seems clear that people's fear of this epidemic's devastating impact on the economy is too often driving decisions for reopening. I believe we should promote the preferable approach to let medical and public health experts determine the safest ways to move forward.
[1] Hospital Bed Usage & Availability, Arizona Department of Health Services
[2] Hospital ICU Beds Census and Staffed Availability as Reported in ESS, State of Florida Agency for Health Care Administration�[3] ICU Bed Usage, Southeast Texas Regional Advisory Council�[4] Texas Case Counts COVID-19, Texas Health and Human Services�[5] Texas,
Covid Act Now has real-time COVID data and risk level for your community. See how your community is doing at covidactnow.org.
