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Here are the daily reports of hospitalizations (rate of change from prior day) and deaths (rate of change from prior day, or from the prior recorded report if one or more daily reports are missed) from the Ohio Dept. of Health. Anybody feel free to update this chart in the event that I am unable to or forget to do so. Until the rate of change begins to decrease over many days if not weeks, this epidemic won't have begun to peak in Ohio.
Beginning 3/25/20, Ohio added ICU (intensive care unit) hospitalizations to its daily COVID-19 report. Ohio's report is not very good and does not explain the statistics. E.g., I'm assuming that these are cumulative death statistics, but that hospitalizations reflect current hospitalized COVID-19 patients and ICU patients and not just new daily patients; if so, the hospitalization and ICU statistics are net of discharges, reported by some states which report cumulative hospitalizations and discharges as well as current hospitalized patients.
So for each day, hospitalized patients are listed first, then ICU patients (beginning 3/25), then cumulative deaths.
Gov. DeWine announced that Battelle Memorial Institute had developed hydrogen peroxide vapor machines each capable of sterilizing 80,000 masks per day, pending FDA approval. Two machines initially would be deployed in Ohio, adding about 160,000 masks daily to Ohio's mask supply.
Here are the daily reports of hospitalizations (rate of change from prior day) and deaths (rate of change from prior day, or from the prior recorded report if one or more daily reports are missed) from the Ohio Dept. of Health. Anybody feel free to update this chart in the event that I am unable to or forget to do so. Until the rate of change begins to decrease over many days if not weeks, this epidemic won't have begun to peak in Ohio.
Beginning 3/25/20, Ohio added ICU (intensive care unit) hospitalizations to its daily COVID-19 report. Ohio's report is not very good and does not explain the statistics. E.g., I'm assuming that these are cumulative death statistics, but that hospitalizations reflect current hospitalized COVID-19 patients and ICU patients and not just new daily patients; if so, the hospitalization and ICU statistics are net of discharges, reported by some states which report cumulative hospitalizations and discharges as well as current hospitalized patients.
So for each day, hospitalized patients are listed first, then ICU patients (beginning 3/25), then cumulative deaths.
Excellent news. For the first time since beginning this analysis, all three growth rates have fallen below 20 percent. Ohio's social distancing policies seem to be achieving the desired effect of flattening the patient case load in an attempt to avoid overloading Ohio's health system as is occurring in NY City. In 30 days at a 10 percent growth rate, Ohio's total deaths to the COVID-19 epidemic will reach 506; at a 15 percent growth rate, 1,920; at a 20 percent growth rate, 6,884. The power of compounding.
The news today from Ohio's administration was on efforts to get the FDA to approve a full and immediate ramp-up of Battelle Memorial Institute's new mobile, mask-sterilizing machines, each of which can sterilize 80,000 used masks per day using a hydrogen peroxide vapor technology. Two machines, with a 160,000/day capacity would initially be located in Ohio.
Earlier Sunday, the FDA approved only a 10,000 mask/day trial. Gov. Michael DeWine labeled this decision "reckless" and immediately appealed to President Trump, and apparently the FDA will approve the full rollout of the technology shortly.
<<Minutes before the press conference, DeWine had a phone call with FDA Commissioner Stephen Hahn, who advised the governor “this was going to be cleared up today,” DeWine said.
“We’re not there yet. We’ve not gotten the approval,” DeWine said. “But I’m grateful for the call and I’m hopeful.”>>
Here are the daily reports of hospitalizations (rate of change from prior day) and deaths (rate of change from prior day, or from the prior recorded report if one or more daily reports are missed) from the Ohio Dept. of Health. Anybody feel free to update this chart in the event that I am unable to or forget to do so. Until the rate of change begins to decrease over many days if not weeks, this epidemic won't have begun to peak in Ohio.
Beginning 3/25/20, Ohio added ICU (intensive care unit) hospitalizations to its daily COVID-19 report. Ohio's report is not very good and does not explain the statistics. E.g., I'm assuming that these are cumulative death statistics, but that hospitalizations reflect current hospitalized COVID-19 patients and ICU patients and not just new daily patients; if so, the hospitalization and ICU statistics are net of discharges, reported by some states which report cumulative hospitalizations and discharges as well as current hospitalized patients.
So for each day, hospitalized patients are listed first, then ICU patients (beginning 3/25), then cumulative deaths.
Ohio Department of Health Director Dr. Amy Acton disclosed in the daily press conference that Ohio had conducted more than 27,000 COVID-19 tests to date.
Here are the daily reports of hospitalizations (rate of change from prior day) and deaths (rate of change from prior day, or from the prior recorded report if one or more daily reports are missed) from the Ohio Dept. of Health. Anybody feel free to update this chart in the event that I am unable to or forget to do so. Until the rate of change begins to decrease over many days if not weeks, this epidemic won't have begun to peak in Ohio.
Beginning 3/25/20, Ohio added ICU (intensive care unit) hospitalizations to its daily COVID-19 report. Ohio's report is not very good and does not explain the statistics. E.g., I'm assuming that these are cumulative death statistics, but that hospitalizations reflect current hospitalized COVID-19 patients and ICU patients and not just new daily patients; if so, the hospitalization and ICU statistics are net of discharges, reported by some states which report cumulative hospitalizations and discharges as well as current hospitalized patients.
So for each day, hospitalized patients are listed first, then ICU patients (beginning 3/25), then cumulative deaths.
Bad day, as the growth rates are accelerating again.
My fear is that residents with COVID-19 symptoms from New York City, Detroit, Chicago, New Orleans, and perhaps other cities facing prospectively serious shortages of ventilators in their home regions are traveling to Cleveland, as Cleveland's relatively large inventory of ventilators has been noted in articles. What's scary is that such individuals may be flying to Cleveland, perhaps infecting many others while on their journey, raising substantially community spread in Greater Cleveland.
Persons making this journey most likely would include the elderly and those with preexisting conditions that increase the risk of COVID-19 infections. Such persons may be denied ventilators in hard-hit cities due to expected triage once ventilator capacity is exceeded.
Such an exodus from areas facing ventilator shortages of individuals seeking to survive the COVID-19 epidemic would seem inevitable. Of course, such an exodus will challenge the effectiveness of Ohio's social distancing policies, accelerate the stress on Cleveland's and Ohio's limited medical resources, and eventually result in triage at Ohio facilities to the detriment of Ohio residents.
As well as the DeWine administration has done in implementing social distancing policies, it's data collection policies, especially of testing data, has been dangerously deficient. Now, Ohio immediately needs to collect information about the residence of persons testing positive, admitted to both hospitals and ICUs, and of persons dying from COVID-19 in Ohio.
Compare the information reported by Florida, including residence information, with information reported by Ohio at the above state link.
To my knowledge, Ohio does not have an archive of its daily reports.
Yesterday (see post 13) was the first time in many days that Ohio Department of Health Director Dr. Amy Acton reported total COVID-19 tests in Ohio. It is surprising she had this number, as Ohio has said recently that it didn't require the reporting of negative test results. See the following Scientific American article, in which Ohio was singled out as one of only 7 states NOT reporting negative and total test results.
<<
Several states are reporting only positive COVID-19 test results from private labs, a practice that paints a misleading picture of how fast the disease is spreading.
Maryland, Ohio and others are posting the numbers of new positive tests and deaths, for instance, but don’t report the negative results, which would help show how many people were tested overall.
“This matters because it gives you a false sense of what is going on in a particular location,” said Dr. Eric Topol, director of the Scripps Research Translational Institute. He said states should be required to report both positive and negative results for review by public health experts....
Melanie Amato, press secretary for the Ohio Department of Health, said her state is collecting only positive test results as many private labs have begun testing residents....
“We don’t require private labs to report negative labs in any infectious disease,” she said. Asked if that policy might change, she said: “That is a discussion for later down the road.”>>
So has Ohio collected negative and total test results retroactively, allowing Acton to state yesterday that 27,000 total tests had been administered in Ohio?
Former Food and Drug Administration Commissioner Scott Gottlieb explained why collecting total, positive and negative test results is vital to managing the epidemic, as quoted in the Scientific American article:
<<...in a tweet last week [Gottlieb] noted that the nationwide 10% figure for positive test results is “significantly higher” than in the United Kingdom, South Korea and China.
“Until we see the positivity rate decline significantly, we are still not screening enough,” Gottlieb wrote.>>
It's important to identify infected individuals so that they will self-quarantine, even within their own home from the rest of their families. Increased testing and contact tracing to identify asymptomatic carries is one of the most important tools used to control an epidemic. Neither DeWine nor Acton discuss this reality.
The Ohio stay-at-home order was issued to reduce the need for testing, given the paucity of testing resources available in Ohio and nationally (shockingly still a mystery over two months after South Korea was able to roll out mass testing). So there likely are asymptomatic individuals working in essential businesses that are spreading the infection -- e.g., grocery and other (Wal-Mart, Target, Home Depot, etc.) retail clerks, first responders, and even healthcare workers. In a good control system, all customer-facing personnel would have masks, gloves, and be regularly tested for the COVID-19 virus.
<<Amid these dire trends, South Korea has emerged as a sign of hope and a model to emulate. The country of 50 million appears to have greatly slowed its epidemic; it reported only 74 new cases today, down from 909 at its peak on 29 February. And it has done so without locking down entire cities or taking some of the other authoritarian measures that helped China bring its epidemic under control....
Behind its success so far has been the most expansive and well-organized testing program in the world, combined with extensive efforts to isolate infected people and trace and quarantine their contacts. South Korea has tested more than 270,000 people, which amounts to more than 5200 tests per million inhabitants—more than any other country except tiny Bahrain, according to the Worldometer website. The United States has so far carried out 74 tests per 1 million inhabitants, data from the U.S. Centers for Disease Control and Prevention show.>>
If Acton's total Ohio tests was accurate as of 3/30, ten days after the above article, Ohio, given its population of 11.69 million, had a testing rate of only 2310 persons/million, likely because of the rollout of independent testing at Cleveland's Cleveland Clinic and University Hospitals.
Note that South Korea's testing as front-loaded, and combined with massive contact tracking, and imposed self-isolation, South Korea consequently was able to stop the COVID-19 epidemic without shutting down its economy. As of 3/30, South Korea had only 158 COVID-19 deaths, equivalent to about 1,000 deaths in the U.S. adjusted for population (again, South Korea has not found it necessary to shut down its economy to reduce community spread, relying instead on massive testing and contact tracing and individual isolation).
On NBC's "Today" show on 3/30, White House Coronavirus Task Force response coordinator Dr. Deborah Birx said we'll be fortunate to hold the U.S. death toll to 100-200,000:
<<She predicts that “if we do things together well, almost perfectly, we could get in the range of 100,000 to 200,000 fatalities,” but adds, “we’re not sure all of America is responding in a uniform way.”
I grew up in Mahoning County, saw a news story about the infection rate m, and looked at their numbers. It’s super high for the population size. Why so high in that region?
Here are the daily reports of hospitalizations (rate of change from prior day) and deaths (rate of change from prior day, or from the prior recorded report if one or more daily reports are missed) from the Ohio Dept. of Health. Anybody feel free to update this chart in the event that I am unable to or forget to do so. Until the rate of change begins to decrease over many days if not weeks, this epidemic won't have begun to peak in Ohio.
Beginning 3/25/20, Ohio added ICU (intensive care unit) hospitalizations to its daily COVID-19 report. Ohio's report is not very good and does not explain the statistics. E.g., I'm assuming that these are cumulative death statistics, but that hospitalizations reflect current hospitalized COVID-19 patients and ICU patients and not just new daily patients; if so, the hospitalization and ICU statistics are net of discharges, reported by some states which report cumulative hospitalizations and discharges as well as current hospitalized patients.
So for each day, hospitalized patients are listed first, then ICU patients (beginning 3/25), then cumulative deaths.
Best numbers yet for hospitalizations and ICU usage, and the growth rate in deaths retreated from the escalated levels of the last few days. Higher death totals may have reduced significantly the 4/1 ICU number. There have been 159 deaths in the last three days, and 4/1 ICUs beds utilized total only 222....
Ohio Department of Health Director Dr. Amy Acton yesterday prohibited hospitals from sending their COVID-19 tests to commercial laboratories due to long delays in receiving test results. Instead, the tests will be sent to Ohio clinic laboratories, such as the one at the Cleveland Clinic.
This order likely was necessary, but nonetheless represents a major reduction in Ohio testing capacity.
A friend of mine was admitted to a Columbus hospital not affiliated with Ohio State Hospitals with a bad skin infection and COVID-19-like symptoms on Thursday, March 26. He was given a COVID-19 test and the results of the test were not back by yesterday, April 1. He felt fully recovered within two days after an intravenous dose of antibiotics, but doctors are keeping him under isolation until the COVID-19 results are obtained; my friend was told he will be discharged immediately if his COVID-19 test is negative. This obviously represents a massive cost to his health insurer if he tests negatively for the COVID-19 virus.
Quest Diagnostics IMO should be sanctioned, if not sued, as it has greatly imperiled the nation's struggle with the COVID-19 epidemic. It's very possible my friend's test was sent to the Quest laboratory in CA.
I do wonder if all commercial lab testing is slower than at Ohio clinic labs, especially as the commercial labs introduce automated testing as discussed in the above article, and whether it is worth the cost of reducing Ohio testing capacity by banning all commercial testing. A logical system would request lab turnaround times, and restrict testing at those labs without quick turnaround times, especially if actual turnaround times are slower than promised turnaround times.
Here are the daily reports of hospitalizations (rate of change from prior day) and deaths (rate of change from prior day, or from the prior recorded report if one or more daily reports are missed) from the Ohio Dept. of Health. Anybody feel free to update this chart in the event that I am unable to or forget to do so. Until the rate of change begins to decrease over many days if not weeks, this epidemic won't have begun to peak in Ohio.
Beginning 3/25/20, Ohio added ICU (intensive care unit) hospitalizations to its daily COVID-19 report. Ohio's report is not very good and does not explain the statistics. E.g., I'm assuming that these are cumulative death statistics, but that hospitalizations reflect current hospitalized COVID-19 patients and ICU patients and not just new daily patients; if so, the hospitalization and ICU statistics are net of discharges, reported by some states which report cumulative hospitalizations and discharges as well as current hospitalized patients.
So for each day, hospitalized patients are listed first, then ICU patients (beginning 3/25 when Ohio first began reporting this statistic), then cumulative deaths.
To keep posts in this thread from becoming too long, five-day reports will replace daily statistics using compounded rates of change (calculated using a business calculator). Daily statistics will remain available in earlier threads. Five-day compounded rates of change are marked by an asterisk. The 5-day death growth rate from 3/20 to 3/25 likely was distorted by having only 1 death as the starting point.
On 4/3 and 4/4, growth rates have declined significantly. Hopefully, single digit increases will be seen in the near future.
I personally still worry about Detroit and Michigan, if not New York City patients traveling from these hard-hit areas for treatment. I've seen no evidence that Ohio is tracking this obvious risk.
The most significant developments of the last few days is that Gov. Mike DeWine says he will now wear a face mask in public and requests all Ohioans to wear face coverings. Obviously, massive shortages of face masks currently make the purchase of such masks difficult.
Also, Gov. DeWine said Ohio State University will make swab test kits to distribute to small hospitals as tests are otherwise not available.
On Friday, DeWine said Ohio State University and the Ohio Department of Health would work together to produce swab test kits to distribute to smaller hospitals because they weren’t available from vendors.
Ohio also is planning a random test of asymptomatic Ohioans to determine how many cases of COVID-19 might be present in Ohio. The initial planned sample of 100 persons is almost statistically worthless, however. Given the state's population of 11.3 million, the sample size would have to be almost 4 times as large to have much validity.
Here are the daily reports of hospitalizations (rate of change from prior day) and deaths (rate of change from prior day, or from the prior recorded report if one or more daily reports are missed) from the Ohio Dept. of Health. Anybody feel free to update this chart in the event that I am unable to or forget to do so. Until the rate of change begins to decrease over many days if not weeks, this epidemic won't have begun to peak in Ohio.
Beginning 3/25/20, Ohio added ICU (intensive care unit) hospitalizations to its daily COVID-19 report. Ohio's report is not very good and does not explain the statistics. E.g., I'm assuming that these are cumulative death statistics, but that hospitalizations reflect current hospitalized COVID-19 patients and ICU patients and not just new daily patients; if so, the hospitalization and ICU statistics are net of discharges, reported by some states which report cumulative hospitalizations and discharges as well as current hospitalized patients.
So for each day, hospitalized patients are listed first, then ICU patients (beginning 3/25 when Ohio first began reporting this statistic), then cumulative deaths.
To keep posts in this thread from becoming too long, five-day reports will replace daily statistics using compounded rates of change (calculated using a business calculator). Daily statistics will remain available in earlier threads. Five-day compounded rates of change are marked by an asterisk. The 5-day death growth rate from 3/20 to 3/25 likely was distorted by having only 1 death as the starting point.
Very significantly, 4/5 marks the first day since Ohio began releasing the ICU patient total that the growth rate has been in single digits. This means that discharges and deaths are catching up with new admissions to the ICU!
The 5-day growth rates also continue to show moderation.
This death/case ratio is a great concern.
<<The state reported 826 cases for Cuyahoga County on Sunday, part of the 4,043 cases confirmed in state. Of those 4,043, 119 have died.>>
So the cumulative death/case ratio is 3 percent. Admittedly, Ohio still is testing only persons with the most severe COVID-19 symptoms, those with symptoms and the greatest vulnerability (e.g., over 60 or with preexisting conditions), or those with the greatest risk (first responders, healthcare workers).
I wonder if the DeWine administration is contemplating the loan of some Ohio ventilators to Detroit or New York. By lending ventilators to Detroit, Ohio may reduce the number of COVID-19 patients fleeing the Detroit area hotspot for treatment in Ohio. Of course, the potential of such Detroit area patients fleeing Michigan for treatment in Ohio is perhaps the best reason for Ohio not to loan out any currently surplus ventilators. And ventilators also require the trained staff necessary to run the machines and provide care for intubated patients.
We shouldn’t be loaning out anything when we have our own problems to deal with.
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