Tag: coronavirus

There are signs that the upward trajectory on test positivity is leveling off or even decreasing – unfortunately, with Thanksgiving less than a week away, I’m afraid this won’t last. We’ll get a much better handle on the situation in roughly two weeks or so, after the impacts from Thanksgiving start to show in the test and case data.

Almost all measures of test positivity are better or no worse than one week ago, with the exception of higher education testing, for which positivity rates are marginally higher than one week ago. But higher education results are still better than any other category.  One other item to note: assuming statewide records are accurate, about 45% of the Massachusetts population has now been tested at least once for coronavirus.  Because of widespread higher education testing, the total number tested in Massachusetts (over 3 million) may include out-of-state college students, which would inflate the numbers somewhat.

I’ve added back a line to the Table outlining hospitalization statistics – New Confirmed Admissions.  After dropping this from the daily dashboard report, the state recently added it back to the weekly public health report.  It is only updated weekly, so I’ve included the as-of-date of November 17 in the report.  This also means that the figures for 7 days ago are as of November 10, and the figures for four weeks ago are as of October 20. 

Since hospitalizations lag cases (and case numbers are still increasing), it isn’t surprising that hospitalizations are continuing to increase, but the rate of increase might be slowing down. Still, the 7 day average of Covid patients in the hospital are up one-third from one week ago, but ICU patient are up less than 15%, and intubated patients are up about 10%.  Newly admitted patients increased by slightly more than 30%.

Cases are continuing to rise despite the leveling off of positivity rates, but at a slower rate than before – the 7 day average of confirmed cases is up only about 9% over the past week.  However, the state reported 2,991 confirmed cases on November 21, the second highest number of confirmed cases ever reported (the highest was on April 23), and 3,206 confirmed and suspected cases, the highest total yet. However, on April 23rd the 7 day average positivity rate for newly tested individuals was 24% compared to 10%.  There were also over 3800 patients in the hospital on April 23rd.

And, not surprisingly, deaths are also rising (it is now more than two months since the case increases started after Labor Day), with a 65% increase in the 7 day average rate compared to four weeks ago.  However, now about half of deaths are in long-term care facilities, compared to about 70% for most of the pandemic.   

Are the testing and case metrics beginning to level off in Massachusetts? Test positivity for newly tested individuals was 10.9% today, and has been between 10.8% and 11.1% for the past five days. Unfortunately, this type of holding pattern happened once before recently, when the newly tested positivity rate held at 6.6% and 6.7% for seven consecutive days near the end of October and the beginning of November. It is way to soon to draw any conclusions, especially with Thanksgiving coming up. This test positivity holding pattern seems to be in place not only for newly tested individuals, but for repeat testers (0.5% and 0.6% rate for twelve days), and higher education testers (0.3% rate for eight days) as well.

Of course, hospitalizations lag cases, and the Covid patient count continues to accelerate, with over 30 net new patients added to the Massachusetts hospital rosters each day on average over the past week (versus about 20 net new patients daily over the prior week).  In the short run, ICU and intubated patient counts are leveling off, as are the ratios of ICU to total Covid patients, and intubated patients to ICU patients.

Confirmed reported cases have topped 2000 for seven of eight days now – the only day under 2000 was yesterday (and the data released on Monday tends to have light totals reflecting cases reported on Sunday).  The number of reported cases have leveled off somewhat, reflecting the short-term leveling off of test positivity rates.  Deaths are slowly increasing, reflecting the increases in cases from several weeks back.

No surprises, although Massachusetts did hit several negative milestones in the past several days – test positivity rates of 10% for those newly tested, test positivity rates of 5% outside of higher education, and an overall test positivity rate of 3%. The total number of tests continues to increase, but slowly, and the percentage of first-time testers remains about 25%.

Hospitalization statistics are back to where they were in early to mid-July, but of course the numbers were headed down then, and they are now headed up.  Unfortunately, total hospitalizations are increasing at a faster clip – Massachusetts’ hospitals added almost 170 patients in the last 7 days compared to just under 100 in the 7 days prior to that.  It also appears that patients are a bit more ill than they were four weeks ago, as the percentage of hospitalized patients in the ICU, and percentage of ICU patients who are intubated are higher than they were.

A higher test positivity rate naturally leads to more cases – we’ve had over 2000 reported confirmed cases each day this week.  That number may drop Sunday and Monday, as reporting tends to slow down over the weekend.  The 7 day average of reported deaths, which had been somewhat held in check, hit 24 today for the first time since July 2.   On July 2nd, 70% of those deaths were in long-term care facilities compared to 53% today, which implies that healthier people are dying now.

Nothing good to report today. Test and case positivity rates are still increasing, and at a faster rate than before. No matter which measure of positivity at which one looks, the rate is double or triple what it was four weeks ago. The one exception is for repeat testers, for which the rate is approximately 50% higher, based on 7 day trailing averages. Test positivity is even increasing in higher education (albeit from a very low level), which had been the standout for quite some time. Keep in mind that there is a very large overlap between repeat testers and higher education testers.  Most people tested in higher education have been tested multiple times.

And of course, hospitalizations are rising too, and almost as fast as positivity rates. The 7 day trailing average number of ICU patients has more than doubled from four weeks ago, and the number of intubated patients has almost tripled.  Hospitals in the state added almost 20 patients per day over the past week  (this is not new admissions, but net new admissions including discharges and deaths).

The only slightly positive news is that deaths haven’t dramatically begun to increase (and given better treatment options this might be the case going forward). The 7 day average of reported deaths had stayed under 20 per day from mid-July until October 22 (over three months), but it hasn’t moved much higher since then (let’s keep our fingers crossed). Cases are skyrocketing of course, with the 7 day average tripling since four weeks ago.

This is the last post for this blog.  As many of you know, after election day, Covid disappeared. So there were no new cases, no new hospitalizations, and no new Covid deaths in Massachusetts today, nor will there be any going forward. There is no point in continuing this blog.

Just kidding of course. Unfortunately, the coronavirus news in Massachusetts is not good, and is continuing to get worse. The test positivity rate for newly tested individuals reached 7% today after being between 6% and 7% for twelve consecutive days. I’d been hoping we were at a plateau. No such luck. Positivity rates for higher education, which had been 0.1% throughout September and October, ticked up to 0.2%.  The number of tests each day continues to increase slightly, but the large increase in confirmed cases is not from increased testing, but from higher positivity.

As test positivity and cases rise, hospitalizations follow.   The 7 day average count of hospitalized patients, patients in the ICU, and intubated patients all increased by almost 25% or more in one week.  Particularly disturbing is that over 50% of patients in the ICU are intubated, the highest rate since early September.

Over 2000 new cases were reported today, and the 7 day average of new confirmed cases topped 1300, the highest amount since mid-May.  Deaths are holding steady.  It is unclear whether this is because of the lag from diagnosis to death, or because the current batch of covid patients is healthier compared to the spring. 

Happy Election Day. I’ve had some time to digest the new dashboard from Massachusetts and the file download that accompanies it. I’m disappointed in the changes to the dashboard, but it isn’t as bad as it looked at first glance. However, it seems to me that the state still is trying to highlight statistics that paint the pandemic in Massachusetts in a more positive light, as I noted yesterday.

First, new individuals tested and their test positivity rate are not shown on the dashboard (this is what I reacted to yesterday). The newly-tested positivity rate is significantly higher than the positivity rate for repeat testers and about 75% of all tests currently are for repeat testers. However the testing information for new testers is still in the data download, if not on the dashboard itself.

The second significant change is to the hospital reporting. The state now only reports confirmed covid hospitalized patients, ICU patients, and intubated patients. This led to a fairly sizeable drop (almost 30%) in the overall patient count based on October 31st data.  Presumably, the suspected case patients are still in the hospital, regardless of whether they are counted by the state in the official tally.  However, the state did provide a backhistory of these confirmed hospitalization statistics, so it is possible to compare these data over time.  In addition, the state dropped the ‘New Daily Admissions Report’ altogether.  I had used this in my data updates, and have a less than satisfactory replacement.

In general, the state’s reporting of hospitalizations has been quite poor. The state’s cumulative hospitalization figures never matched that of hospitals, and once the state went to weekly reporting of hospitalizations by age group, the fourteen day totals in the weekly report never came close to matching the totals from the race / ethnicity report. I had used the race / ethnicity report to calibrate my estimates for hospitalizations by age group.  Furthermore, the state dropped the race / ethnicity report from the dashboard in this latest update.  As a result, it’s unclear that I’ll be able to provide meaningful estimates of hospitalizations by age group going forward. 

Test positivity rates have held steady for the past several days – the first somewhat positive news in the last several weeks.  With the dashboard revision, the state appears to be providing daily, rather than weekly, updates on higher educational testing (not all the changes made by the state were misguided).  I’ve included them in this report.  As I’ve indicated in prior posts, higher education positivity rates are extremely low, and almost half the testing in the state since September 1st has been for higher education (https://www.masscoronavirus.net/massachusetts-college-testing-update-october-26-2020/). This higher ed testing has kept “all test” positivity lower than it would be otherwise, as Table 1 shows. 

I’ve revamped the hospitalization report shown in Table 2.  As noted previously, I’m now using the state-provided data for confirmed cases only.  In addition, I’m now showing the average daily net change in hospitalizations, ICU patients, and intubations over the last week.  For example, there has been an increase of 12 net hospitalizations over the past week, meaning that there are now approximately 84 (12 times 7) more hospitalized confirmed patients than one week ago.  The increase in the number of hospitalizations is greater now than it was four weeks or even one week ago. 

The structure of Table 3 is unchanged.  The 7 day average of reported confirmed cases remains above 1,000, even though the state reported only less than 1,000 confirmed cases for the past two days.  The death rate is holding steady, but has gone up a bit over the past several weeks.  Now that the state has converted all the graphics on its ‘Dashboard of Public Health Indicators’ graphics to 7 day trailing averages, you will notice some difference between my figures and those provided by the state for the number of cases and number of deaths. 

This is because I am calculating the 7 day averages using the cases and deaths reported each day, and the state is calculating its averages using the cases and deaths on the day they occurred (the “as-of” date), rather than the day they are reported.  I favor the state’s approach, but only with a lag to account for the fact that there is a lag in the reporting of deaths and cases so that the most recent days undercount the eventual totals for those days.  Consequently, I expect that the numbers reported on the ‘Dashboard of Public Health Indicators’ will tend to be lower than those I report.