Coronavirus, Late April Edition, 2022
The Numbers:
Nationwide,
the estimated number of cases has been rising slowly now, by
about 1% per day. 85% of the new cases in the USA are the sub variant of the original Omicron variant.
I
based new cases identified, we are hovering around 500,000 total cases
currently with the virus. 11,000 are hospitalized, up from 10,150 a week ago, down from 12,800 a month ago.
Paxlovid
This is just a summary, for more information see the article from Yale Medicine.
Paxlovid is an anti-viral therapy of 3 pills. The clinical trial has demonstrated an 80% reduction in the risk of hospitalization and death.
What you need to know: Paxlovid will be available at around 20,000 pharmacies. If you test positive for Covid, they will issue you an impromptu prescription for an immediate treatment. So no second step going to your doctor, then a third back to the pharmacy.
Bring a list of the medications you are currently taking. There is a list of drugs Paxlovid interacts with that needs to be cleared first.
What is nice to know: It is actually 2 different drugs. One, nirmatrelvir,
prevents replication of the Covid protein, the other, ritonavir, shuts down
the nirmatrelvir processing in the liver, so nirmatrelvir will have a longer
time to work.
How under counted are the number of cases?
I have heard or read the the under count of actual cases range from 7% the actual number (yes 1/14th) to 30% the actual number. A wide variation and both are far from accurate. Most watchers are now switching from number of cases to "Trends". Is number of cases going up or down? And estimating from there. There are a couple of ways of estimating the under-count. One is testing the waste water stream for markers. Others involve polling.
The reason for the under count is simple enough. The current dominant variant is milder, and so fewer patients require hospitalization, and many just suffer through without an official test, or take a home test and not report it.
Watchers of the pandemic are monitoring the hospitalizations from Covid. I never tracked that, so I have no history conveniently available. However, everywhere I look say the numbers are way down.
Europe's numbers from "Stealth Omicron" are coming down. The surge it caused in Europe seems to have passed by the US. I have been hearing for about 7 weeks now that we are usually 4 weeks behind Europe. Justifications (IE Excuses) seem to be because our unvaccinated community was ravaged by Delta/Early Omicron, that just about everyone in the US is either vaccinated or recently exposed. But I think this applies to most of Europe as well. Their vaccination rate was better than the US, 76% have 2 doses vice 67%, and Stealth Omicron surged there. I think it is simply that their health systems are managing their numbers better.
Is the total cases relevant?
Not so much any more. I think the hospitalization rate is more important. Society as a whole has 12 stepped it's way to acceptance. The current version of Covid is 3 times deadlier and 6 times more infectious than the common flu. Alpha was over 100 times deadlier and 2 times as infectious. We as a whole now regard the deaths from here on as acceptable losses. An impromptu poll has taken place when it was announced that the federal judge, Kathryn Kimbal Mizelle, tossed out the mask mandate. Her reasoning was, the CDC, whose mission is to "protect America from health, safety and security threats", over reached to protect America from a health threat. But if you sweep the crowd videos, about 3/4 of the people were cheering, 1/4th was disgusted.
Alabama is Back!:
This is not really important except to my fellow counters. For about 18 months, the state of Alabama stopped reporting its numbers for "Total Recovered" and "Active Cases". They are now reporting those cases again. 1,204,517 and 73,062 out of a population of 4,903,000. Alabama was one of the reasons why I stopped using the Active Cases number reported to the CDC and went to an algorithm to calculate the active cases rather than rely on what the states were reporting.
Alabama was not alone among the states to do this. They were just the most obvious, because I sort alphabetically and their numbers are at the top of the list. Most states lost track of recovered patients. Who goes back to the doctor to report they are well now? For anything? A number of states went to an algorithm like mine, others simply would do a reassessment of the total cases and overnight, those numbers would drop 50% or more. Florida was the worse offender, and at one time Florida had 20% of all the active cases in the country, because they never updated their "Recovered" numbers. Truly, it was Florida that forced me to deviate from reporting the CDC numbers directly. And updated with a calculated number instead. There is nothing evil or conspiratorial about this. It's just bureaucracy trying to keep up with reality.
Though Florida's death counts continue to use a back dated version of the numbers, which makes the today's deaths smaller, while backdating the deaths in the past.
For the variants, up to and including Delta, I used the formula of adding up the previous 3 weeks of cases, and then added 6% for ICU cases, and reported that as the number of "Active Cases". For Omicron, I have adjusted the calculation to 2 weeks + 3%. And Omicron still had over 10 million cases at one point. Alpha peaked at 5.2 million the year before.
I was working with Delaware Health and Human Services (DHHS) last year and got a peek at what it takes to change reporting to the CDC. The departmental politics to change anything is daunting. We are not talking Rep. v Dem politics, just control issues of which department does what. I was assigned a project to upgrade their Sexual Transmitted Disease program to the CDC because Delawares program was using a database called "Foxpro", which was no longer going to be supported by Microsoft. My job was to totally replace the program.
While I was gathering requirements, I found out the CDC built the program I was replacing, and built a replacement program, and had already established a process to upgrade, and this process had already been executed in over 25 states. So the choice for DHHS was adopt the CDC program, which was cheaper, well vetted, will have regular updates. Or a program that will not be as full featured, not work as well, no vetted and would not have regular updates, but would have the features they control, and not beholden to to some federal organization.
They decided to lay me off while they discussed this. The fact there was a discussion is disconcerting. They had a budget for programmers, but not one for upgrades. Bureaucracy.
And FYI, by my calculations, Alabama should have about 2,900 active cases, not 73,000.
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