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Massachusetts Data Update October 16, 2020

Well, I was clearly wrong about test positivity rates stabilizing.  The positivity rate for newly tested people is now over 4%.  That rate bottomed out at 1.4% on August 30, increased to 2% by September 8, rose to 3% on September 26, and hit 4% on October 13th.   Even the overall test positivity rate has increased to 1.4% after bottoming out at 0.8% on September 23.  And test positivity for repeat testers is now 0.4%, after holding steady at 0.2% for over a month until October 8th.  Not a good trend.

Table 1: Massachusetts Testing Statistics
7 Day  Trailing Average
October 16, 2020
         
Testing Statistic   Current 7 Days Ago 4 Weeks Ago
         
Test Positivity Rate (Individuals)   4.1% 3.5% 2.2%
Test Positivity Rate (Include Suspected)   4.5% 3.7% 2.4%
         
Test Positivity Rate (All Tests)   1.4% 1.1% 0.8%
Test Positivity Rate (Newly Tested)   4.1% 3.5% 2.2%
Test Positivity Rate (Repeat Testers)   0.4% 0.2% 0.2%
Percentage Repeat Testers   72.5% 73.7% 71.5%
         
Newly Tested (Lagged 1 Week)   17,365 15,976 14,638
All Tests (Lagged 1 Week)   65,978 59,072 49,123

 The total number of patients in the hospital, patients in the ICU, and patients intubated have held roughly steady for about a week, but at significantly higher levels than four weeks ago. The most troubling statistic here is the new hospital admissions, which are at their highest levels since June 30th. Given the rise in positivity rates and diagnosed cases over the past several weeks, this is not that surprising.

Table 2: Massachusetts Hospitalization Statistics
7 Day Trailing Average
October 16, 2020
         
Hospitalization Statistic   Current 7 Days Ago 4 Weeks Ago
         
Covid Patients Hospitalized   510 474 332
Covid Patients in ICU   85 84 62
Covid Patients Intubed   30 29 23
New Confirmed Patients   39 35 19
         
Percent ICU / Hospitalized   17% 18% 19%
Percent Intubated / ICU   35% 35% 37%

 

Diagnosed cases have not been this high since the end of May, with the 7 day average of confirmed cases over 600 for four days in a row.  The 7 day average number of reported deaths broke through the fairly tight range of 11 to 17 from mid-July (surprisingly, the 7 day average of reported deaths was 11 as recently as October 10).  Clearly, Massachusetts is headed in the wrong direction.  Is this the beginning of the second wave, or just an uptick in a continuing first wave?  Will Charlie Baker et. al. move to roll back openings? 

 

Table 3: Massachusetts Reported Case and Death Statistics
7 Day Trailing Average
October 16, 2020
         
Statistic   Current 7 Days Ago 4 Weeks Ago
         
Total Deaths Including Suspected   18 12 13
Total  Deaths Confirmed Only   17 12 13
Deaths in Long-Term Facilities (All Cases)   12 12 9
Percent from Long-Term Care   65% 93% 69%
         
Total Cases Including Suspected   665 581 371
Total Confirmed Cases   620 542 338

9 replies on “Massachusetts Data Update October 16, 2020”

So based on these numbers and past trends, when should we be seeing a rise in deaths? Also is there any way to determine by numbers why Massachusetts has done so poorly with death rates in elder care facilities compared to other states? Finally is there any way to predict based on numbers what might happen if we opened the schools fully?

As I’ve said before, I’m not an epidemiologist, just someone who is good at number crunching. But based on the numbers, if we’re going to see a rise in deaths, it should be in the next few weeks. But I’m not sure we will see much of a rise in deaths. Why? Because 70 percent of our deaths are in long-term care facilities, and 95 percent of deaths are for people 60 and over (a rate that hasn’t changed much since the beginning of June). Based on the evidence so far, more of the case increase is in a younger population with low death rates, meaning any increase in deaths would be muted.

I can’t answer why we have such a high percentage of deaths in long-term care facilities. To me, this is one of the mysteries of the deaths in Massachusetts. Are we just doing a better job reporting deaths? I don’t know. It’s hard for me to believe that facilities in Massachusetts are less well run than those in other states. I might have thought it was because our death rates were much higher in early days of the pandemic, when the states in the Northeast were the most hard hit and nobody knew exactly how to prevent and treat Covid. But this very high death rate continues.

I’d have to think that if we opened schools fully cases would increase even more, but once again I am no expert. Children, even if you could get them to wear masks 100% of the time, could easily be a source of asymptomatic spread. These decisions are always based on trade offs between health and safety on one hand, and a desire to resume normal economic and social life on the other. It is very difficult to strike an appropriate balance, because there are costs and benefits no matter how you balance things.

I’ve heard elected officials say, “There’s nothing surprising here; we expected this,” regarding the increase. For those of us who track the data closely, perhaps, although I don’t think anybody in the general public is prepared for an increase of any magnitude. My fear is that there will be an “overreaction” to the rising numbers.

I’m pretty skeptical of the official response. Of course, if you open up society more it has to be more difficult to keep the case, hospitalizations, and death rates in check. However, I can’t believe Baker and the powers that be are happy that the state in aggregate is in the red zone by their own definitions. Is there going to be an overreaction? I’m not sure, as the state has put its own spin on the numbers to try to mute any reaction to more cases and higher positivity (and the public suffers from Covid fatigue). From my perspective, the key will be hospitalizations. We aren’t anywhere close to the peak level of hospitalizations, but the trend is pretty disturbing. Hospitals are operating more normally now, with appointments for non-Covid issues and elective procedures etc. If we have to shut them down again because they are overwhelmed with covid patients, it would be a disaster.

I think an important distinction is that epidemiologists know one thing well, and statisticians know another, and the two talk about the same thing but from different points of view, and I appreciate you pointing that out.

Whenever I point to numbers, I’m always faced with hostility and the “oh, I didn’t know you were a scientist, John.” But I’m only looking at empirical data, and empirical data don’t lie.

Hospitalizations are rising, but I just don’t see a dramatic or dangerous trend. ICU rates are so low. Here in Boston, there’s no noticeable increase in hospitalizations at all, even as positives increase. (And, the increase isn’t from college students or partiers in South Boston, no matter how hard people try to prove it is.)

I agree that hospitalization rates right now aren’t that concerning. However, to me the issue with covid is I don’t see increases in cases, etc. as symmetric with decreases (that was certainly empirically true in the Northeast in the first round. It seems to me is much more difficult to slow down (like a conflagration) once it gets out of control. We’re not there yet, and this latest outbreak isn’t anything compared to March and April, but I’m still worried.

I wholeheartedly agree about college students, as I’ve posted about here before. And as far as South Boston is concerned, it is certainly grabbing the headlines right now, but the positivity rate there recently is lower than the city average (you probably already knew this, I just looked at the City of Boston’s covid website for the first time).

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