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COVID-19 detected in United States

Jacob

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No doubt about that, we got crushed this week pretty hard and had to setup impromptu treatment areas in corridors that have never housed hallway patients. I've seen my fair share of patient overloads but this week was the worst. The hospital being full was a big factor in that and all the rooms housing covid(+) patients means we have a lot less to work with; so there's not just a problem of where to put suspected covid-19 cases but all medical emergencies.

How does this compare to spring cases and summer cases, as far as the average patient goes? Obviously the volume is way up, but back in the summer I think I remember you remarking how the average case was more mild than the cases you were seeing in the spring.
 

KoD

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How does this compare to spring cases and summer cases, as far as the average patient goes? Obviously the volume is way up, but back in the summer I think I remember you remarking how the average case was more mild than the cases you were seeing in the spring.
Good question, currently the average case leans towards the moderate end of the spectrum with a lot of people in various age groups (with and without substantial medical history) having shortness of breath from small amounts of exertion. Lots of them will have drops in oxygen sat while walking around (into the 80s) and even if they're otherwise doing okay, that usually gets most everyone into the hospital, steroids, etc.. There's also a noticable increase in the amount of positive cases we catch in patients who didn't come in for covid-19 related complaints.
 

Evan

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I'm becoming cautiously optimistic that the current COVID surge is abating somewhat. Still very early and need to see a continued trend for a good week or so, but the post-Thanksgiving surge seems to have peaked somewhat. Really hope that's true.
 

Jacob

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I'm becoming cautiously optimistic that the current COVID surge is abating somewhat. Still very early and need to see a continued trend for a good week or so, but the post-Thanksgiving surge seems to have peaked somewhat. Really hope that's true.

I'm not sure if you are speaking locally or nationally. From my perspective, nationally it is slowing down because about 15 states are post peak and falling, while another 4-5 are at peak/steady. It still has to finish burning through the SW, NE, and is just ramping up in the deep-deep south (Houston, New Orleans, Mobile, Florida) this round. Locally, I'm not seeing a peak yet here in the hospitalization data, but I'm hoping we see Huntsville peak in the next few days.

Also, I see no signs of a Thanksgiving spike across the country on a wide-scale. I'm sure some local outbreaks were influenced, but on a large scale the outbreak just continued following the same pattern and Thanksgiving appears to be nothing more than a little noise in the signal. Do you disagree?
 

Jacob

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Maybe the first signs out of Huntsville of hospitalizations possibly nearing a peak?

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Lori

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What do each of you do to try and prevent catching Covid?

I wear my mask, I try not to go in stores unless absolutely necessary. I wash my hands after anything, even after pumping gas. I avoid super spreaders like packed restaurants, churches and Christmas shopping.

Before this started and now, I take Vit D (magnesium for Vit D absorption), Vit C, L-lyzine, Zinc, Elderberry and a multiple vitamin.
I’m eating healthy and trying to get back to exercising.

The only people I’m around is my family but only my kids but not my 73 year old parents.

I took a huge risk and officiated my sis in law’s wedding in Montgomery a few weekends ago. All of that side of the family has had Covid. I wore a mask and the wedding and reception was outside but I still got tested 5 days later. Negative!!

I take small trips to the outdoors to continue my photography but nothing indoors if possible.

It’s still likely I’ll get Covid but I’m doing my best to avoid infecting myself and others without being a total recluse.
I won’t get to take the vaccine due to being in the category of highly allergic (I carry an epi-pen) so if I get jt, I pray it’s a mild case.

The first wave killed and affected my in laws. The second wave has infected friends and is killing them as well!!

I am scared!!
 

ghost

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What do each of you do to try and prevent catching Covid?

I wear my mask, I try not to go in stores unless absolutely necessary. I wash my hands after anything, even after pumping gas. I avoid super spreaders like packed restaurants, churches and Christmas shopping.

Before this started and now, I take Vit D (magnesium for Vit D absorption), Vit C, L-lyzine, Zinc, Elderberry and a multiple vitamin.
I’m eating healthy and trying to get back to exercising.

The only people I’m around is my family but only my kids but not my 73 year old parents.

I took a huge risk and officiated my sis in law’s wedding in Montgomery a few weekends ago. All of that side of the family has had Covid. I wore a mask and the wedding and reception was outside but I still got tested 5 days later. Negative!!

I take small trips to the outdoors to continue my photography but nothing indoors if possible.

It’s still likely I’ll get Covid but I’m doing my best to avoid infecting myself and others without being a total recluse.
I won’t get to take the vaccine due to being in the category of highly allergic (I carry an epi-pen) so if I get jt, I pray it’s a mild case.

The first wave killed and affected my in laws. The second wave has infected friends and is killing them as well!!

I am scared!!
I wear a mask regularly and have avoided restaurants that do not socially distance the tables. I have actually only eaten out maybe 6-7 times all year. I have attended a few church services where we socially distance and wear masks but have decided in this surge to worship online for a few weeks. I do help coach a Jr High basketball team and I wear a mask at practice and at the games. I know this is risky but I have decided to do it. I go to the grocery store and Walmart occasionally always masked and heavy use of hand sanitizer while there and afterwards. I need to be better about washing my hands.

I occasionally take Vitamin C, D, several Bs, and Zinc. I occasionally take Elderberry. Even though there is only cursory evidence of benefits, I take Pepcid AC and Melatonin. I have also had a flu shot and a Dr. I know also recommended the MRR shot kids take and I got it too. I will take the vaccine when it is available to me
 

StormStalker

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My sister-in-law had to have an outpatient procedure done and they tested her before the procedure and it was positive. She has zero symptoms. My brother also has zero signs but he has not been tested. She had the test Friday and I was around her this weekend so I guess it’s just a waiting game now. They told us we could get tested if we wanted but we could also wait to see if we develop symptoms.

edit: I’ll take the vaccine when it’s available to me. Hoping to maybe get it a little sooner since I work in higher education but I doubt it’s all that much sooner.
 
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Jacob

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I'm not sure if you are speaking locally or nationally. From my perspective, nationally it is slowing down because about 15 states are post peak and falling, while another 4-5 are at peak/steady. It still has to finish burning through the SW, NE, and is just ramping up in the deep-deep south (Houston, New Orleans, Mobile, Florida) this round. Locally, I'm not seeing a peak yet here in the hospitalization data, but I'm hoping we see Huntsville peak in the next few days.

Here's an updated map showing where hospitalizations are rising and falling. This again is the 7 Day Moving Average of Hospitalizations per 10M people.

12-Dec16.png
 

Evan

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I'm not sure if you are speaking locally or nationally. From my perspective, nationally it is slowing down because about 15 states are post peak and falling, while another 4-5 are at peak/steady. It still has to finish burning through the SW, NE, and is just ramping up in the deep-deep south (Houston, New Orleans, Mobile, Florida) this round. Locally, I'm not seeing a peak yet here in the hospitalization data, but I'm hoping we see Huntsville peak in the next few days.

Also, I see no signs of a Thanksgiving spike across the country on a wide-scale. I'm sure some local outbreaks were influenced, but on a large scale the outbreak just continued following the same pattern and Thanksgiving appears to be nothing more than a little noise in the signal. Do you disagree?

Nationally.

I think there was definitely a post-Thanksgiving surge because from November 16-24th, the average daily rise in cases really started to level off even when considering that a lot of people were getting tested as a pre-clearance for Thanksgiving along with the increased testing because of the sharp uptick over the preceding two weeks.

Even if you go and backfill data from the immediate post-Thanksgiving period into the time around Thanksgiving to account for the holiday delays with testing, reporting, and data collection, you'd have still seen a bit of a leveling off before cases started to surge again over the past two weeks. Has it been as aggressive of a surge as the Halloween to Thanksgiving period? No. But, it's definitely a fairly sizable surge.

It could be argued the same surge would've occured despite Thanksgiving, but I think that's not that convincing to me because of how cases started to level off some in the 11/16 - 11/24 range that I mentioned above.

As I posted a few days ago, I was cautiously optimistic that maybe we were seeing another period of cases leveling off, but with yesterday's big case dump we're going to need to see some days with declining numbers again to see the average drop again.

I think trends are really challenging to monitor on a daily basis which is why I really prefer to look at things on a weekly basis or on a rolling 7-day average.

I'm not quite as optimistic as I was a few days ago, but as I just stated one day does not make a trend, so we may still be headed in the right direction.

I've seen some anecdotal metrics recently that taken in conjunction with more statistically valid data, that paint a picture of Americans really cutting back on their Christmas activities and curtailing get-togethers, parties, and group events. I hope that's true.

My only concern is that we'll knock cases down for a few weeks only to relax our guard and see another set of surges. It all depends on people's activity levels and dedication to following mitigation recommendations until vaccinations have made a real dent in the overall population of those who lack COVID immunity. I think it's fair to say that the vast vast majority of Americans still lack immunity, and accordingly until that number begins to rise through vaccinations we will be susceptible to periods of surging COVID cases. I'm quite optimistic, however, that the worst case scenario of cases continuing to surge throughout winter without abatement doesn't seem very likely anymore. People are clearly changing their behavior and actions whenever cases surge, especially locally/regionally, and I continue to be convinced that's the root cause of the trends you've previously pointed out where certain areas "roll over" so to speak.
 

Evan

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What do each of you do to try and prevent catching Covid?

I wear my mask, I try not to go in stores unless absolutely necessary. I wash my hands after anything, even after pumping gas. I avoid super spreaders like packed restaurants, churches and Christmas shopping.

Before this started and now, I take Vit D (magnesium for Vit D absorption), Vit C, L-lyzine, Zinc, Elderberry and a multiple vitamin.
I’m eating healthy and trying to get back to exercising.

The only people I’m around is my family but only my kids but not my 73 year old parents.

I took a huge risk and officiated my sis in law’s wedding in Montgomery a few weekends ago. All of that side of the family has had Covid. I wore a mask and the wedding and reception was outside but I still got tested 5 days later. Negative!!

I take small trips to the outdoors to continue my photography but nothing indoors if possible.

It’s still likely I’ll get Covid but I’m doing my best to avoid infecting myself and others without being a total recluse.
I won’t get to take the vaccine due to being in the category of highly allergic (I carry an epi-pen) so if I get jt, I pray it’s a mild case.

The first wave killed and affected my in laws. The second wave has infected friends and is killing them as well!!

I am scared!!

Lori, I am so sorry to hear how COVID has continued to impact you and your loved ones. I think you are taking reasonable precautions. I'd say I'm taking pretty much the same precautions as you and ghost, and I'm also working from home 90% of the time as is my wife (who is 100% now and has been since April).

I truly feel for those who don't have the work from home luxury or for various reasons can't avoid stores, restaurants, etc like my family and I can. My parents have been virtual shut-ins since March. No family events. Church online. Grocery delivery. No stores unless absolutely critical, and even then it's for a brief period and not a full shopping trip. Other than doctor's appointments, they're simply not going out.

When I visit them we stand outside masked and over 6ft apart. It has been incredibly tough on them and the grandkids (obviously me as well), but they're both at very high risk so there's little alternative until vaccination is available for them.

I believe I've eaten at a restaurant 3 times since March. Once was an obligation, but it was for only 30 minutes. The other time, we were extremely distanced from other people and took a lot of precautions.

I'm at fairly high risk myself, so I don't see my friends all that often and when I do I take a lot of reasonable precautions. Probably my biggest exposure risk is the fact I have children in daycare/school, but thankfully thus far both my son's daycare and my daughter's school have had very limited outbreaks. My daughter is very conscientious about wearing her mask. Virtual schooling just wasn't a good fit for her so once her school offered in-person again she immediately went back. I'm hearing rumblings that her school system may move back to virtual after Christmas break, but I think it all depends where Alabama is come early January.
 

Jacob

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Nationally.

I think there was definitely a post-Thanksgiving surge because from November 16-24th, the average daily rise in cases really started to level off even when considering that a lot of people were getting tested as a pre-clearance for Thanksgiving along with the increased testing because of the sharp uptick over the preceding two weeks.

Even if you go and backfill data from the immediate post-Thanksgiving period into the time around Thanksgiving to account for the holiday delays with testing, reporting, and data collection, you'd have still seen a bit of a leveling off before cases started to surge again over the past two weeks. Has it been as aggressive of a surge as the Halloween to Thanksgiving period? No. But, it's definitely a fairly sizable surge.

It could be argued the same surge would've occured despite Thanksgiving, but I think that's not that convincing to me because of how cases started to level off some in the 11/16 - 11/24 range that I mentioned above.

As I posted a few days ago, I was cautiously optimistic that maybe we were seeing another period of cases leveling off, but with yesterday's big case dump we're going to need to see some days with declining numbers again to see the average drop again.

I think trends are really challenging to monitor on a daily basis which is why I really prefer to look at things on a weekly basis or on a rolling 7-day average.

I'm not quite as optimistic as I was a few days ago, but as I just stated one day does not make a trend, so we may still be headed in the right direction.

I've seen some anecdotal metrics recently that taken in conjunction with more statistically valid data, that paint a picture of Americans really cutting back on their Christmas activities and curtailing get-togethers, parties, and group events. I hope that's true.

My only concern is that we'll knock cases down for a few weeks only to relax our guard and see another set of surges. It all depends on people's activity levels and dedication to following mitigation recommendations until vaccinations have made a real dent in the overall population of those who lack COVID immunity. I think it's fair to say that the vast vast majority of Americans still lack immunity, and accordingly until that number begins to rise through vaccinations we will be susceptible to periods of surging COVID cases. I'm quite optimistic, however, that the worst case scenario of cases continuing to surge throughout winter without abatement doesn't seem very likely anymore. People are clearly changing their behavior and actions whenever cases surge, especially locally/regionally, and I continue to be convinced that's the root cause of the trends you've previously pointed out where certain areas "roll over" so to speak.

Thanks for the reply. I disagree with your interpretaton of a Thanksgiving surge and also the root cause of "roll over" states, but I enjoy the discussion.

As far as cases, I see a smooth curve from November 1st to Dec 16th, with data collection issues from around Nov 23-Dec 5 due to Thanksgiving. If there was truly a slowing of cases followed by a sizeable surge, we should be able to find that in the hospitalization data, but that doesn't exist. Here's the 7 Day Avg Hospitalization data vs. the 7 Day Avg case data nationally (cases are scaled by 1/2 to fit on the same scale)

Hospitalizationvs-Cases.png


Hospitalizations have continued the smooth increase, while cases caught back up once testing fully caught back up. I suspect regionally you would see the same thing, but I don't have the time to put that data together at the moment.

I do agree with your point about monitoring with a 7 day average vs. daily trends. I've found the hospitalization a much more reliable metric (even though it will be 7-10 days behind the actual progression of the virus spread), and isn't as susceptible to the day-to-day jumps that you get in testing.

As far as your last point about people changing behavior which causes rollover, I haven't seen any data to support that assertion. Mobility data hasn't changed drastically in areas that have peaked and began decreasing. If any state would prove that theory out, you'd think it'd be California, as they have had the most strict restrictions since this began, but they are surging the worst of any state currently.
 

StormStalker

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I ended going and getting tested this afternoon. Wasn’t as bad as I expected it to be. My sister-in-law began running a fever last night and my brother said he was starting to have very mild symptoms. He was also tested this afternoon.
 

Lori

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I’ve been hearing a lot about viral load. As in how much someone gets exposed can affect how bad their symptoms will be... has anyone else heard this? I’ve not researched yet but maybe we all can and then chime in!!
 

Jacob

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Kentucky appears to have rolled over, Tennessee has had a drop in hospitalization numbers for the last 3 days, but that could be weekend data issues. If Tennessee is indeed peaking, N Alabama won't be far behind.

I use hospitalization data to try and determine areas I think are past-peak, but with the built in lag from infection to hospitalization, and then the lag from peak hospitalization until the numbers start dropping, hospitalization numbers don't start dropping until 10, 15, maybe 20 days past the true peak of infection spread. Kentucky likely peaked right around Thanksgiving, ER visits peaked 4-5 days later, and hospitalization data peaked the first week of December, stayed steady for 10 days or so, and then started dropping in the last few days.

With that said, it is possible Tennessee and North Alabama have already peaked as far as infection spread goes. I hope that is the case, and hospitalization numbers start dropping in Tennessee and peak in Alabama shortly.
 

Jacob

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I'm becoming cautiously optimistic that the current COVID surge is abating somewhat. Still very early and need to see a continued trend for a good week or so, but the post-Thanksgiving surge seems to have peaked somewhat. Really hope that's true.

To further your point here, it looks to be slowing all across the Northeast. NY/ME/VT/NH/MA/CT/RI/DE/NJ/MD all look like they may be at peak or approaching peak, and % of CLI ER visits across the region have largely stopped increasing. Hospitalization cases in those have flattened out (and decreased in some) over the last week or two. Hopefully that trend continues.

The only place where it seems to be completely on fire currently is California/Arizona. It's bad in the other parts of the sunbelt (such as Alabama, Georgia, Florida, etc.), but California is outpacing everybody at the moment. Take California out of the picture and nationally a lot of your metrics, such as cases and hospitalizations, have been steady/dropping for the last couple weeks. Alabama's 7 Day MA on Hospitalizations (per 10MM) is +62, while California sits at +139. They are currently doubling Alabama's rate on a per-capita basis.
 

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My parents and my Covid test came back negative. My sister-in-law is feeling better but my brother has been running fever. My brother hasn’t heard from his test yet but he probably will soon.
 

KoD

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Got my first vaccine dose today, I've never been so happy to get a shot.
 

StormStalker

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Got my first vaccine dose today, I've never been so happy to get a shot.
Sounds like you are doing okay with it. Hopefully they can get it out to the rest of us sooner rather than later.
 
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