Today we stand at 46.6 cases / 100K / day, down from 47.3 yesterday. Practically speaking, the new cases rate is unchanged over the last week. In total (not shown on chart), daily cases are down about 9% from the 9/1/2021 peak.
Data source for this and other graphs of new case counts: Calculated from The New York Times. (2021). Coronavirus (Covid-19) Data in the United States. Retrieved 9/17/2021, from https://github.com/nytimes/covid-19-data.” The NY Times U.S. tracking page may be found at https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html.
The abrupt change in trend following Labor Day is starting to look more and more like a simple data reporting anomaly. We’ve had those with prior holidays. You can track my painful process of discovery in Post #929 from last year, where I finally got my facts straight on how major holidays affect reporting of tests, and testing itself.
We never saw any data anomaly the size of this most recent one from any minor holiday in the past. Not from Labor Day, Memorial Day, July 4th, or any other one-day holiday before. That’s why I didn’t think it could possibly be simple data reporting issues. But, possibly, now that states no longer report data daily, any sort of holiday may lead to a a deeper disruption of the reporting of new cases. In any case, assuming that’s just an artifact of the holiday, then the size of it differs from the past, for some reason.
Source: CDC COVID data tracker.
A bit of confirming evidence is that there was no corresponding change in hospitalizations (yellow line above). If we look at the CDC COVID data tracker, we see that hospitalization reached a peak around 9/1/2021 and have declined smoothly since.
There are no reporting or behavioral issues for hospitalization, corresponding to those issues for testing. COVID-19 hospitalizations are reported directly to the U.S. D.H.H.S. from hospitals. And, in most cases, it’s not optional. If you need an inpatient standard of care, that’s what you need, and it doesn’t really matter what day of the week it is, or whether or not your state public health department is open that day.
In the graph above, I’ve circled three instances where nothing happened. By that I mean, in hindsight, I now see that the hospitalization data has always been free of the post-holiday artifacts that plague the reported new cases data. As such, it provides a straight-up real-time test of whether or not a blip in the new cases curve is merely a post-holiday anomaly.
The only reason I didn’t realize that all along is that these hospitalization data are new. Nothing like this chart was available from CDC (or any other Federal agency) in the fall of 2020, when these holiday reporting anomalies became evident.
Idaho
One potential exception to the rule that the hospitalization trend is more robust than the new-cases trend is situations such as Idaho, where the hospitals are full, and admissions are being constrained by hospital capacity. But, so far, that’s rare enough that I think it will not matter for the U.S. picture.
Idaho is an odd case, for a lot of reasons. You’ve probably been reading that the hospitals are so filled that they are now triaging patients based on likelihood of survival. Where there are more COVID-19 patients than there are beds and ventilators, physicians are legally authorized to use those scarce beds for patients whom they judge most likely to survive. That’s contrary to normal practice, where beds go first to those in greatest need of them.
I don’t mean to imply that this hasn’t happened implicitly before in this pandemic. Physicians will tighten the criteria for hospital admission as beds get filled. The interesting thing in Idaho is that the state of emergency declaration for hospitals provided the legal authorization for Idaho physicians to make the hospitalizations decision based on likelihood of survival, instead of the more normal “need for care”. Generally, you admit the sickest first. Here, priority is given to the likely survivors first.
What’s odd is that Idaho doesn’t have a lot of new cases. They barely make it into the top ten states. There are states that have a much heavier case load, based on the reported positive tests per 100,000 population per day.
The issue is two-fold. Unusual for such a rural state, Idaho doesn’t have many hospital beds.
Source: Kaiser Family Foundation
And, for whatever reason, Idaho is having a lot of hospitalizations per diagnosed case. Compare the gap between hospitalizations and cases for Idaho, with the identical chart for the U.S. above. If I had to guess, I’d guess that’s probably an artifact of a population that’s less willing to get tested. So it’s not an excess of hospitalizations, it’s probably that the new case count understates the true extent of illness in the state, relative to the U.S. average.
Why do I think citizens of that state are less likely to get tested? I guess I’ve seen this happen enough times over the pandemic that I’ve gotten a little jaded. It’s because they’re less cooperative with every other aspect of pandemic citizenship.
You’ve got a state that won’t wear masks:
Source: Carnegie-Mellon University COVIDcast.
And they won’t get vaccinated:
Source: CDC COVID data tracker.
And the crap hits the fan, and the hospitals fill up. And then somebody decides to do something. Or maybe not, in the case of Idaho. And eventually new cases hit a peak. And we forget about it until the next time it happens.
I guess I’m a little jaded at this point, having seen this play out in a number of states now. I guess I have empathy fatigue.
The governor of the state issues an order that boils down to “let them die as necessary”, and Idaho citizens basically do nothing. And their government does less than nothing.
If they don’t care, why the hell should I? At some point, you just can’t fix stupid. We get the government we deserve, and Idaho apparently deserves this. As a prelude to having patients die for lack of hospital beds.
Source: Idaho House Bill 121 (2021).
