Michigan vs. Ohio State Football today postponed due to COVID

But a comparison of MI vs OH on COVID is useful

Why?

While vaccines are coming, we have 6-8 hard weeks ahead

And the big question is -- can we do anything to save lives?

Lets look at MI, OH for insights

Thread
On 11/15, Michigan announced series of restrictions

Ohio didn’t

We can compare the two to see if Michigan policies helped

Why is Ohio a good comparison?

OH a neighbor of similar size, make-up (urban/rural, etc)

Here's COVID cases through 11/15

(OH in red, MI in blue)
The two states have tracked very closely

Similar states

Similar policies

But then, things changed mid-November

So let’s talk data (@COVID19Tracking 7-day moving avgs)

3/9
On 11/15, Michigan had

67 new cases / 100K population and 31 people in the hospital per 100K pop

Ohio had, per 100K pop

58 new cases, 25 people in the hospital

And as the graph shows, they were both increasing rapidly

Here's that graph again through November 15
Michigan put in restrictions on 11/15

Ohio did not

What happend?

Michigan 11/15 versus 12/10

Daily cases: 67 --> 57 new cases per 100K
Hospitalizations: 31 --> 40 per 100K

Ohio 11/15 versus 12/10

Daily cases 58 -->104 new cases per 100K

Hospitalizations: 25 --> 44 per 100K
So MI: cases are down 15%, hospitalizations up 29%

OH: cases are up 79%, hospitalizations up 76%

And you know that deaths will follow in the following couple of weeks

In fact, let's look at the picture, which tells the story perfectly

OH vs MI through December 11
For much of the pandemic, the two states have looked very similar

Partly because both governors did a good job managing things

When things got bad this fall, MI responded, OH didn’t

If we need more evidence that policy matters, this graph should do it

5/6
Two states, similar background, neighbors

Only big difference is in mid-November, a policy intervention

And effects are sizeable. And visible.

Obviously, its just a two state comparison

But compelling

And should remind us we know how to save lives until vaccines arrive

Fin

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More from @ashishkjha

7 Dec
Something concerning happening tomorrow in Senate Homeland Security Committee

Sound familiar? It is

@RonJohnsonWI holding part II hearings on Hydroxychloroquine

Prominent Anti-vax & pro-hydroxychloroquine doctors (yes, they exist) will be there

We have a response

Thread
The hearings are meant as a questioning of the scientific process

To sew doubt on what we know and how we know it

So a group of us organized a response, which we just posted on our website

It isn't pro or anti hydroxy

Its about the scientific method and why it matters

2/3
Signatories are many of the leading experts medicine, biomedical science

There are other experts we didn't get to ask (sorry)

Not arguing that you should trust me or us over others

You should trust the scientific method

And the scientific community that tries to get it right
Read 5 tweets
5 Dec
There were 225,000 new cases identified yesterday

Sat through Monday, cases will dip (usually do)

But we are now seeing Thanksgiving effect

Based on yesterday's cases alone

Expect 5K-6K hospitalizations 12/11 (if hospitals can accommodate)

and 4,000 deaths on 12/26

Thread
225K yesterday is starting to incorporate Thanksgiving infections

After every holiday, we see cases rising Thursday/ Friday after

I expect next week’s case numbers to climb higher

Thanksgiving surge just beginning so things could get worse

But there is hope here

2/5
They could get worse because after every holiday weekend, the surge begins Thursday/Friday after

And keeps going for a while

So we could easily get to 250K cases a day and keep rising

But here's what might help

In some places, people are starting to respond

3/5
Read 5 tweets
1 Dec
There is something funny happening with COVID hospitalizations

Proportion of COVID pts getting hospitalized falling

A lot

Just recently

My theory?

As hospitals fill up, bar for admission rising

A patient who might have been admitted 4 weeks ago may get sent home now

Thread
So what do I mean "proportion of COVID pts hospitalized falling"?

For months, you could reliably predict new hospitalizations

How?

By taking cases 7 days prior, multiplying by 3.5%

That is

3.5% (1 in 29) of those diagnosed today will be hospitalized about 7 days later

2/10
LOTS of caveats to this formula

Not all states report new hospitalizations (formula takes that into account)

Could build a 10 day lag formula (3.7% hospitalized by 10 days)

All data I report are 7-day moving avgs from @COVID19Tracking

3/10
Read 17 tweets
1 Dec
Scott Atlas resignation from @WhiteHouse comes not a moment too soon

His time was marred by barrage of misinformation, from promoting anti-mask quackery to falsehoods about testing

He repeatedly tweeted disingenuous "data" & promoted widespread infections as a strategy

Thread
He supposedly was a policy expert, but in my 2 decades of working on US health policy, he was never a serious player

Scott rose to prominence saying on TV what pandemic experts would never say

And found a buyer for his herd immunity strategy in @realDonaldTrump

2/3
.@ScottWAtlas elevated @SunetraGupta, Bhattacharya & @MartinKulldorff...herd immunity advocates who wrote shameful "Great Barrington Declaration"

They claimed to promote "protect the vulnerable" & let others get infected strategy...but didn't do much to protect vulnerable

3/4
Read 4 tweets
23 Nov
If its Monday -- it must be more vaccine news

@UniofOxford / @AstraZeneca vaccine results posted

This is largely more good news

Overall efficacy of 70% but one dosing regimen was 62%, other 90%

A key result reported was safety: no severe adverse events reported

Short thread
What do these results mean and is this actually good news?

Why yes it is

First, I don't fully understand why two dosing regimens were so different in efficacy

One possibility is vector immunity

This vaccine uses adenovirus vector (virus to deliver the genetic material)

2/4
Less efficacious arm used full dose of vaccine in both shots

More efficacious arm was half dose followed by full dose

It MAY be that the full first dose generated immunity against vector, causing second dose to be less effective

We don't know but will need to sort out

3/4
Read 5 tweets
23 Nov
Daily reports tell us what happened last week, 2 weeks ago, 4 weeks ago

This is why folks are worried about what's next

Today's 7 day moving avgs

167K cases, 3600 new hospitalizations, 1460 deaths

What does this tell us about upcoming weeks?

It says we have a problem

Thread
Today's 167K cases? infection happened last week

Today's 3600 new hospitalizations?

Infections happened about 12-15 days ago

Today's 1460 deaths?

Infections happened about 3+ weeks ago

And that's why we have a problem

2/4
About 3.5% of identified cases get hospitalized

CFR right now about 1.7%

So today's new cases will cause:

5000 new hospitalizations in 10 days

2900 new deaths in 3 weeks

Corollary

Today's hospitalizations were cases 10 days ago

Today's deaths were cases 3 weeks ago

3/4
Read 7 tweets

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