Some Coronavirus Data Updates

By June 23, 2020 Commentary

So I am again going to show you the national and the Minnesota data on the spread of cases and hospitalizations and deaths.  And the reason I keep bringing this up is because this is what should be driving public policy, but still really isn’t.  The Centers for Disease Control is currently showing 103,339 deaths.  As I usually do, given the way they break out age brackets, we will just compare those age 24 and under with those 75 and over.  Unfortunately, the CDC does not use the same dates or have as complete a data set for hospitalizations and cases.  There are 151 deaths in those 24 and under, out of a population of 104 million.  A population death rate of .00015%.  Vanishingly small risk.  There have been 61,964 deaths in the 75 and over group out of a 22 million persons, or a death rate of .28%.   That is a relative risk of death 1866 times greater for that older group than the younger one.  CDC does give us hospitalization rates updated weekly.  That risk is roughly a hundred times greater for older persons than young ones.  And in its modeling guidance document, the CDC’s best estimate of the case hospitalization rate for everyone 49 and under was .017 or 1.7% and for those 65 and older was .074 or 7.4%.   The CDC has also noted that hospitalization rates from coronavirus for children are lower than typical influenza year hospitalization rates.

In Minnesota, as of today, there have been 33227 cases confirmed by positive infection test.  There are likely in reality quite a few more than that, but since the state won’t release antibody test results we don’t know possible estimated prevalence.

There have been 1384 deaths, 1095 of which occurred among residents of long-term care facilities, or 79%.  The best estimate I have seen of the population in these LTC facilities is 80,000 people, from a Star Tribune story.  So the fatality rate among LTC residents is 1.36%.  The rest of the state is about 5,600,000 people.  The fatality rate among the rest of the population is therefore 289 divided by that population or a miniscule .005%, that is five one-thousands of a percent.  Much, much lower than many other causes of death.  There have been 7333 cases from the congregate care living setting, so there is a case fatality rate of 15% for those residents.  (Note that the 7333 cases includes workers at the facilities, so the fatality rate is actually higher, for example if 1000 of those cases were actually of workers, not residents, the rate would be 17%.)

Looking just at age group of deaths, out of 699 cases under 5, no deaths, out of 2657 cases ages 6 to 19, no deaths, out of 6539 cases, aged 20 to 29, 2 deaths.  So for people under 30, a case fatality rate of .02%.  On the other end, 1590 cases in 70 to 79 year olds, 270 deaths; 1509 cases in 80-89 year olds, 473 deaths; 863 cases in people over 90, 389 deaths.  The case fatality rate is 28.6%.  Relative case fatality rate, over a 1400 times greater risk if you are 70 or over versus under 30.   Population fatality rate for the under 30s in Minnesota: .000095%.  Vanishingly small, less than one in a million.  Population fatality rate for the 70 and over crowd:  .16%.  Relative population risk for death is 1680 times greater.

The daily data does not include hospitalizations, but the weekly report does, so this hospitalization rate data just goes through June 17.  For people under age 5, there have been 29 hospitalizations, or a case rate of 4.5%.  For those 6 to 19 years old, there have been 75 hospitalizations or a case rate of 3%.  For 20 to 29 year olds, 238 hospitalizations, a case rate of 3.9%.   For those 70 to 79, 550 hospitalizations, or 36% of all cases in this age group.  Those aged 80 t0 89, 464 hospitalizations, or a 32% case rate (I am guessing it drops slightly in this group because of advance directives).  90 and over, 163 hospitalizations, a 19% case rate (and the same likely explanation for a lower rate).  On a population basis, a .016% risk of hospitalization for the 29 and under group, and for those 70 and older, a .16 risk of hospitalization.  So ten times the risk of hospitalization, without taking into account the effect of advance directives.

Please also note that important information about hospitalizations is not routinely reported by Minnesota or any state that I can find.  You would like to know 1) admissions by date; 2) discharges by date; 3) average length of stay (theoretically you can calculate this from 1 and 2); and 4) place discharged to, including death.  It would be further useful to know how many patients had been diagnosed with coronavirus before admission, how many were diagnosed at the time of admission, how many were admitted for another primary reason, even though they had coronavirus disease, and how many acquired coronavirus infection while in the hospital.  Minnesota just gives us the daily census, how many people are in a hospital on a given day for coronavirus.  That tells you bed usage, but doesn’t really reveal much about trends.  Given the nursing home issues, it would be particularly useful now to be able to track place of discharge.  I am guessing not as many people are being discharged to a nursing home.

It is pretty clear to anyone but most of our brilliant political leaders what public policy would follow from these numbers.

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