#COVID-19 in #Tennessee: TN leads the U.S. in cases reported per population this week. This is very serious but raises an important question: How should we interpret the latest numbers? A thread … 1/ nytimes.com/live/2020/12/2…
Let’s be clear on 1 thing: @TNDeptofHealth is correct that hospitals are beyond their “bend” point and quickly heading to their breaking point. We’re at 2,900 hospitalized and rising. A continued surge following the holidays will create a truly dire situation. 2/ 
But what about those case numbers? We’ve had several days of 11k+ reported in a single day…
Q: Are we really seeing daily case numbers that high?
Q: Are we really seeing daily case numbers that high?
A: Not quite.
We’re going to focus here on the question of *tested date vs. reported date* case numbers, not on the extent of cases that were never tested in the first place: given our high positivity rate, we know a substantial number of these exist). 4/
We’re going to focus here on the question of *tested date vs. reported date* case numbers, not on the extent of cases that were never tested in the first place: given our high positivity rate, we know a substantial number of these exist). 4/
The last 2 weeks provides a case study in why using case numbers by date of specimen collection — rather than by date of report — is a more useful metric. 5/
As cases have grown over the ~2 weeks, the state simultaneously has been streamlining their data system to process & report test results. 6/
Leading into #Thanksgiving there were significant delays in processing. We reported this then, noting that the pandemic had receded to about 8 days in our collective “rearview mirror.” 7/
https://twitter.com/VUHealthPol/status/1334522132232015874?s=20
So what has happened since? First, cases did shoot up after Thanksgiving. Mondays are the day of the week with the highest number of cases, by the test date metric.
Since Thanksgiving, we’ve hit ~8-9k cases on several consecutive Mondays. 8/
Since Thanksgiving, we’ve hit ~8-9k cases on several consecutive Mondays. 8/
But what also happened is the state caught up on reporting. Now, our collective view of the pandemic is more like 3-4 days in our rearview mirror—down from 8 just prior to Thanksgiving. 9/
As the state caught up, they were processing cases more quickly, adding to each day’s reported tally. Hence, we saw the days with 11k, 10k, etc. cases reported. 10/
Given the state seems to be caught up, they won’t be adding older cases and it will *look* like the numbers have dropped. We expect closer to an average of 5-6K per day, which is still *extremely* high, but it *will NOT necessarily be because actual case growth has slowed* 11/
The state reports weekly numbers by specimen collection date, and we’d encourage news media and public to follow these numbers, if not already. They provide a more accurate view of how fast the epidemic is spreading. 12/ tn.gov/health/cedep/n…
In sum, we have a #COVID19 spike that continues to stress TN hospitals. We have also seen TN at the top of national rankings, in part due to the state working through a backlog of test results, which ⬆️ the number of reported cases. 13/
When the backlog is cleared and numbers *appear to* drop, we will still have a *serious* hospital crisis.
#WearAMask
#WatchYourDistance
#WashYourHands
#AvoidCrowds X/
#WearAMask
#WatchYourDistance
#WashYourHands
#AvoidCrowds X/
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