Are we ready to lift lockdown?
How would an epidemiologist look at the data to help us understand these questions?
Let me take you through the @CDCgov COVIDView data released today, w some commentary.
cdc.gov/coronavirus/20…
Public Health Surveillance is what the CDC does. Glad they are in the game
Ideally, this would be collected when a specimen is collected!
Zeke brought in the baseball analogy here. Was that slightly condescending or helpful?
statnews.com/2020/03/24/we-…
NY, NJ > 40% (my gosh)
MI, CT > 30%
GA, MA, IL, CO > 20%
PA, DC, MD, IN, LA, DE, VA > 15%
RI, SD, AL, NV, SC, IA, CA, PR, TX, MO, FL, KA > 10%
None of these states should be reopening til + rate is 5% or less
covidmap.aledade.com
Sharpest increases in + rate:
SD went from 10% -> 24% + samples
KY 5%-> 14%
DE 16% -> 25%
MD 19%->26%
SC 6%->13%
VA 15% -> 22%
@GovernorVA doesn't need protestors telling him to open up right now
![](https://pbs.twimg.com/media/EV10Ys7XQAE2Mhc.png)
Let's dive into NYC, because their epis are the best
www1.nyc.gov/site/doh/covid…
The NYT graph made this point visually.
here's another stat- we have seen >15,000 excess deaths in NYC over the past 5 weeks.
Over three waves of the 1918 flu pandemic, there were 30,000 deaths in NYC.
THIS IS NOT FLU
ncbi.nlm.nih.gov/pmc/articles/P…
![](https://pbs.twimg.com/media/EV2ARxCXkAA0wFW.jpg)
ncbi.nlm.nih.gov/pmc/articles/P…
I think we are undercounting cases by 10x+
before we start talking about opening up, we need to get diagnoses up, CFR ~1%
But that only works if you are diagnosing most of the cases
Only loosen when CFR ~1%
ILINet is too coarse to see small outbreaks begin to flare. You need to apply statistical methods to the ED data for that, and I haven't seen states (ex NYC) publicly showing that data.
*Every governor should be asked about their ED surveillance clusters every day*
It could be that people are avoiding outpatient centers and doctors offices and EDs for their cough/ fever due to fear, social distancing.
These signals need to be investigated.
By real public health epidemiologists.
who are local.
I fear that they will be used in one direction but not the other->lives lost