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COVID-19 detected in United States

Jacob

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I've actually been on vacation for the last few days but ER volume seemed to be down over the weekend from where it was covid-wise. Still high but better. I haven't received a report on inpatient stats yet this week.

Hope that remains the case, though I'd be surprised if the Huntsville area has already peaked on hospitalizations.

I'm pretty confident in saying that Alabama/Florida/Louisiana/Mississippi/Arkansas/Missouri have peaked (Georgia and SC just a tad behind), but I'm not sure what that means for the next couple weeks. Last summer's "peak" across much of the area was more of a couple week plateau then a decent drop, compared to January's peak which seemed to flip a switch overnight. (Florida being the exception last summer, they dropped hard and fast)

Jacksonville is the only area in LA/MS/AL/FL with a solid decline in hospitalizations so far, and I'm hoping to see that change this coming week. Baton Rouge's 7 day average decreased yesterday slightly for the first time, so hopefully that's their peak in hospitalizations. Mobile hasn't moved much in the 1-2 weeks, and they seem to be following very closely to what New Orleans/Baton Rouge is doing as well. Hoping to see Miami peak this week as well.
 

Jacob

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Another thing complicating any post-peak predictions is how Delta waves have behaved in other parts of the world. In India, after a brief plataeu in a few places, they fell fast and hard, and generally to a lower floor than before Delta showed up. For example, the Uttar Pradesh region got up to 35k cases a day 5 day average in late April, and their current 5 day average cases is 26 (you read that correctly). The Delhi region saw the same, with about 10+ days with a 5 day average around 25k, and their current 5 day average is 36 cases.

On the flip side, you have the UK, which as we all know saw a dramatic rise and then a quick fall (but only about a ~40% fall from the peak), only to see cases plateau and now they are currently increasing again. Things are a little more muddy there because they opened back up everything right when they peaked, which could be contributing to the current increase.
 

KoD

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Looks like the numbers are down from where they were the past couple weeks, inpatient wise we're at 103 down from 114 last week. Hopefully that trend continues. There's still a steady stream of positives and the rate is ~20% at the hospital and ~24% for the state. Also we're offering vaccines to people in the ER including their family member if they want one, but there's not many takers.
 

warneagle

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Meanwhile Bryan Harsin got COVID after publicly waffling on the vaccine at SEC media days. And this while the team has one of the lowest vaccination rates in the SEC. He's alienated a lot of people at Auburn (myself included) before even coaching a game.
 

KoD

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Looks like the numbers are down from where they were the past couple weeks, inpatient wise we're at 103 down from 114 last week. Hopefully that trend continues. There's still a steady stream of positives and the rate is ~20% at the hospital and ~24% for the state. Also we're offering vaccines to people in the ER including their family member if they want one, but there's not many takers.
Nevermind, hopefully today was a fluke because it was nearly December/January in the ER. Filled the covid area with 100% positive patients and they spilled into the rest of the department with several positives waiting in the "covid lobby" for a room to open up. Thankfully this time there was several extremely well-off (in comparison) vaccinated individuals who added to the total but will definitely be spending the night in their own bed and be completely fine after a few days to a week. The rest will unfortunately feel suffocated if they try to walk around, I've seen two healthy 40-50s year olds gasping for air, scared and asking for the oxygen cannula back after pacing 80ft.
The "rapid antigen" test we've been using is supposed to be read after fifteen minutes similar to an influenza test and generally we'd see a positive line appear after several minutes in symptomatic patients. Since Delta we've often been seeing them show positive in 20-40 seconds. I don't think these mutations are anything to mess around with. I hope everyone gets vaccinated and extremely soon or it could get worse for everyone.
 

Mike S

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Jacob

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Nevermind, hopefully today was a fluke because it was nearly December/January in the ER. Filled the covid area with 100% positive patients and they spilled into the rest of the department with several positives waiting in the "covid lobby" for a room to open up. Thankfully this time there was several extremely well-off (in comparison) vaccinated individuals who added to the total but will definitely be spending the night in their own bed and be completely fine after a few days to a week. The rest will unfortunately feel suffocated if they try to walk around, I've seen two healthy 40-50s year olds gasping for air, scared and asking for the oxygen cannula back after pacing 80ft.
The "rapid antigen" test we've been using is supposed to be read after fifteen minutes similar to an influenza test and generally we'd see a positive line appear after several minutes in symptomatic patients. Since Delta we've often been seeing them show positive in 20-40 seconds. I don't think these mutations are anything to mess around with. I hope everyone gets vaccinated and extremely soon or it could get worse for everyone.

Sorry to hear that. That was largely why I asked a couple days ago. Seems like Jacksonville/New Orleans/Mobile all saw sporatic increases like that right around the top.

Cases in Mobile/Baton Rouge peaked about 2-3 weeks ago, and hospitalizations peaked in both places on Aug 17th (7 day average rolled at both places Aug 20). Jacksonville saw cases peak 4 weeks ago, and hospitalizations peaked around August 8th (7 day average rolled on August 12th). Hopefully you guys will start to notice things slowing down in about another week. Though I haven't seen dramatic decreases anywhere yet, seems like a gradual decrease compared to what we saw in January. In Jacksonville their daily admits have decreased about 35% in the last two weeks, from a 7 day average of 82 to currently 54.
 

South AL Wx

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My wife tested positive for covid this morning. She has migraines pretty often, and her head started hurting last week. She thought is was a migraine, but went to urgent care on Friday and got a covid test. It wound up being negative, but she started having worse symptoms this weekend. She started coughing some, with nasal congestion and a runny nose. This morning, she noticed that her sense of taste had gone away. She went to our family doctor and tested positive this morning. We are both fully vaccinated with the Pfizer vaccine (since April). So far, I haven't had any symptoms. We're just praying that our 3 year old son doesn't get it.

Update: I tested positive today. I started having a scratchy throat on Friday, and had a rapid test done that came back negative. Over the weekend, I started having more symptoms, with a stuffy/runny nose, sneezing, low-grade fever, and loss of taste and smell. The rapid test today came back positive. Thankfully, my wife is feeling a lot better. Our 3 year old started running a low-grade fever last night and is really tired today, so he is seeing his pediatrician later this afternoon.
 

Mike S

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Update: I tested positive today. I started having a scratchy throat on Friday, and had a rapid test done that came back negative. Over the weekend, I started having more symptoms, with a stuffy/runny nose, sneezing, low-grade fever, and loss of taste and smell. The rapid test today came back positive. Thankfully, my wife is feeling a lot better. Our 3 year old started running a low-grade fever last night and is really tired today, so he is seeing his pediatrician later this afternoon.
Get well soon. Hopefully the baby just has a bug
 

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Not good news for us Pfizer vaccinated folks about the Delta variant...
 

Jacob

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Not good news for us Pfizer vaccinated folks about the Delta variant...

I have two comments on the Israeli data.

1) It shows that the vaccine is far, far less effective in stopping spread than many have been lead to believe. At their level of vaccination, they should be seeing significantly less infection than they currently are. This is probably skewed some by testing level differences, but for comparison, their current new cases per 100k is at about the same level as Florida's currently is. There's still some level of reduction, as evidenced by the case rates per 100k (assuming vaccinated and non-vaccinated are tested at the same rates) are still quite a bit higher in the unvaccinated.

2a) I don't quite understanding the squawking about the hospitals in Israel yet. Their number of hospitalized people is still only about 60% of what it was during their winter wave, and the # of ICU patients is less than 1/3 of what they had for much of January/February. Perhaps the biggest concern currently is the speed at which it is increasing.

2b) Despite point 1 above, there's still a very solid reduction in severe disease/hospitalization in the Israeli data among the vaccinated. Not as much as Public Health/Government would lead people to believe that there would be originally, but still a very significant reduction.

Here's the ugly truth that this data shows as it pertains to the US. The northern US is going to see a nasty, nasty fall/winter wave in a couple months. The southern US *might* fare better since so many people have been infected in the summer delta wave, but seeing as how wrong I was about the magnitude of this summer's southern wave, I'm not confident at all that that will be the case.
 

Lori

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Not good news for us Pfizer vaccinated folks about the Delta variant...
I think the booster is needed for those that were the earliest to get the vaccine, immunity may have worn off over time..
 

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Seems pretty clear we're not going to see the rapid decline from peak that other countries and areas have had with Delta. It's going to be a long Fall and Winter since there's such a high baseline in the Southeast and the United States as a whole - especially, in light of the low vax rates in the Southeast.
 

Jacob

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Seems pretty clear we're not going to see the rapid decline from peak that other countries and areas have had with Delta. It's going to be a long Fall and Winter since there's such a high baseline in the Southeast and the United States as a whole - especially, in light of the low vax rates in the Southeast.

I'd like to see another 1-2 weeks worth of data before agreeing that we won't see a solid dropoff before the late fall/winter wave starts. Jacksonville, FL is starting to see things improve at a decent clip now. I'd like to see if some of the other areas that have peaked like Mobile and Baton Rouge start to fall quickly in the next 1-2 weeks (if the hurricane doesn't mess with their data).

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Evan

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I'd like to see another 1-2 weeks worth of data before agreeing that we won't see a solid dropoff before the late fall/winter wave starts. Jacksonville, FL is starting to see things improve at a decent clip now. I'd like to see if some of the other areas that have peaked like Mobile and Baton Rouge start to fall quickly in the next 1-2 weeks (if the hurricane doesn't mess with their data).

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Don't really understand the focus on Jacksonville. Florida's case numbers have stagnated +/- a few hundred to a thousand for some time now. They simply cannot handle cases turning into hospitalizations at the rate they've been occurring with Delta. Without a sustained drop, I don't see how it actually doesn't get worse before it gets better. At best, it makes me think cases will get stuck at a relatively high number and hospitalizations will be slow to decline.

I wouldn't hang my hat on one city in Florida or just one hospital system in a city. We don't know if they're trying to send home less severe patients to free up room for sicker patients or if staffing is preventing them from keeping inpatient numbers as high as the actual demand. I'll also add that we don't know if beds are freeing up due to fatalities.

Point is, at this moment, there's not been a rapid decline in heavily impacted areas like we saw in the UK, India, or other places with rapid flares and peaks. I suspect part of that is due to Americans being less willing to change their behaviors and contact tracing programs that leave a LOT to be desired. We're starting to see school systems, businesses, local governments, and others pick-up contact tracing and quarantine where a lack of government efforts exist. That can only be a good thing considering how transmisible the Delta variant is.

Additional research recently released also shows Delta is more likely to cause a hospitalization than previous variants. That's a cause for concern that also leads me to believe hospitalizations will be slow to fall unless hospitals truly get overwhelmed and are forced to start removing patients from vents and/or beds to accommodate patients which much higher survival odds. It's a truly sad situation in so many ways.
 

Jacob

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Don't really understand the focus on Jacksonville. Florida's case numbers have stagnated +/- a few hundred to a thousand for some time now. They simply cannot handle cases turning into hospitalizations at the rate they've been occurring with Delta. Without a sustained drop, I don't see how it actually doesn't get worse before it gets better. At best, it makes me think cases will get stuck at a relatively high number and hospitalizations will be slow to decline.

I wouldn't hang my hat on one city in Florida or just one hospital system in a city. We don't know if they're trying to send home less severe patients to free up room for sicker patients or if staffing is preventing them from keeping inpatient numbers as high as the actual demand. I'll also add that we don't know if beds are freeing up due to fatalities.

Point is, at this moment, there's not been a rapid decline in heavily impacted areas like we saw in the UK, India, or other places with rapid flares and peaks. I suspect part of that is due to Americans being less willing to change their behaviors and contact tracing programs that leave a LOT to be desired. We're starting to see school systems, businesses, local governments, and others pick-up contact tracing and quarantine where a lack of government efforts exist. That can only be a good thing considering how transmisible the Delta variant is.

Additional research recently released also shows Delta is more likely to cause a hospitalization than previous variants. That's a cause for concern that also leads me to believe hospitalizations will be slow to fall unless hospitals truly get overwhelmed and are forced to start removing patients from vents and/or beds to accommodate patients which much higher survival odds. It's a truly sad situation in so many ways.

The focus on Jacksonville is because they were the first to surge, they are 1-2 weeks ahead of the rest of the state and 2-3 weeks ahead of much of the rest of the SE. What they do, the rest of the SE is likely to follow in a few weeks. The next closest cities in time-line would be Baton Rouge/New Orleans and the Mobile area, which both had hospitalizations peak about 8 days after Jacksonville did. (not sure on Orlando and Tampa, but I haven't found hospital numbers for those areas). I think another 1-2 weeks of data for those cities (plus Miami, which may have peaked in the last couple days) will give us a much better idea of what to expect from this drop. You may be right and we just sit high and simmer for a while, but I think it is too soon to make that call right as areas are starting their declines.

As far as cases in Florida, those are being heavily impacted currently by the increase of back to school testing. Cases are falling in all age brackets 20+. We saw a similar pattern in August last year when schools ramped up testing, cases stagnated, but hospitalizations kept dropping. This obviously isn't limited to just Florida, but it's had a noticeable impact on cases this past week there. They saw a decent drop in % positive this past week though, despite similar numbers of overall cases.

Do you have a link for the last paragraph? I'd like to read the research on it.

Note: I'm not making a "we are definitely going to see a hard fall" prediction. I don't know. I agree that the numbers haven't turned over as quickly as I would've liked to feel confident we were going to fall hard. I've seen some solid improvements in the numbers around Jacksonville and parts of Louisiana this week, so I'm just saying for me I need another 1-2 weeks of data to feel confident in any directional prediction.
 
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Jacob

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I wouldn't hang my hat on one city in Florida or just one hospital system in a city. We don't know if they're trying to send home less severe patients to free up room for sicker patients or if staffing is preventing them from keeping inpatient numbers as high as the actual demand. I'll also add that we don't know if beds are freeing up due to fatalities.

At least in the Baptist Health system in Jacksonville, it is primarily because they've seen a sizeable reduction in the flow of new COVID patients. They started publishing their daily admissions numbers on July 31st

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KoD

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Since I am around covid so much and had the opportunity, I got a 3rd shot of the vaccine as a booster to protect me and my family.
Injected yesterday afternoon, felt great yesterday and felt great today. Just a sore muscle again. Really thought I might get some side effects or Ill but nope, extremely invigorated and happy to have done it. Feel exceptionally lucky to get the opportunity too. Vaccine was gonna get wasted down the sink so grabbing some so I didn't take it away from anyone else. I wish more people would get it so we didn't have to waste so much every day...
For anyone interested I had two Pfizer's initially and this one was Moderna.
 
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