Using Active Cases in Your County in Decision Making?

[JumpyTheFrog]

We’ve had a total of about 1500 cases in my county. The state has started reporting numbers of recovered people in the state. They calculate this by assuming people are better after 14 days for mild cases, and by 28 days for those who are hospitalized (unless they die). Using this metric, my county has about the same number of active cases as it did a month ago, despite entering phase 1 several weeks ago and phase 2 last week. I know there may be a big spike in a week from Memorial Day. So it seems to me that as long as the doubling rate stays above 28 days, the number of active cases is holding steady, and at some number would actually be decreasing.

The kids have been amazingly cooperative, but we’ve been isolated since March 14, so we are feeling more frustrated each week. I’ve now reached the point, after avoiding stores and people for so long, that going to Home Depot to buy grass seed today felt like a treat. I haven’t had an in person conversation with anyone except family  this whole long longer than discussing the lack of zinc at the vitamin store with the clerk.

How would you use the above calculations to influence your decision making about what to begin allowing again for your family?

[Jean in Newcastle]

I am comfortable masking and social distancing while going to any place legally open at this time. I am also comfortable meeting with friends outside while using social distancing. Our county has done well with strict adherence to these measures. 

[almondbutterandjelly]

I'm a little bit of the mindset of at some point, you have to live your life.  I say that, and then I still stay home almost all the time.  We have 250ish cases in my county.  We've only had 3 deaths since this whole thing started, and our hospitalizations are in single digits and have been, since this whole thing started.  Even with a meat packing plant spike and a couple of halfway house spikes.  So we are cautiously venturing out with masks on.  We shopped at Kohls.  We joined the YMCA (haven't attended yet.  Probably next week.).  My dd hung out with her bff a few times, unmasked except when they went to the store.  Our church is still not open except for online.  

I don't know the right answers.  Best of luck as you navigate this.

[catz]

I think it can be helpful to look at ...

• testing rate - can anyone in your area get tested quickly and easily now?
• test positivity rate - ideally below 5% but certainly below 10%
• Hospitalization/ICU numbers and how they are trending
• How your area is reacting. Are people taking it seriously and isolating themselves if they develop symptoms.  Are people masking in indoor public spaces pretty well

I still don't think testing is getting ALL cases most places unless they test an entire company or nursing home or something along those lines.  

Our numbers are still going up.  Most importantly, our ICU numbers are at an all time high.  We are going to peak later in June according to latest models. So although we do go out to walk/bike and do curbside pick up, we are probably going to watch and wait a bit.  

 

Edited May 27, 2020 by FuzzyCatz

[EmseB]

I have tried this, but numbers in my county spiked, but it was solely due to prison tests. So it's still hard to gage the relative risk.

[ktgrok]

19 minutes ago, Patty Joanna said:

 

The number I am watching (not that you can get really reliable info on this either) is the hospitalization rate and death rate.

 

The problem with the death rate is that it can take literally months to get numbers that make sense, because of autopsies, paperwork being done in batches, etc etc. And that's AFTER accounting for the deaths being probably 14 days behind the spike in cases. So, for me, not helpful 😞

I'm looking at new cases, because at this point, we are not going to be increasing testing that much - we are supposedly already able to test anyone with symptoms or contact with someone with symptoms, and I don't see us ever testing just everyone, so that's holding steady. (in my county). So for me, new cases per day is what I'm looking at, and I'm assuming that those are the tip of the iceberg, as plenty of people won't feel sick enough to go get tested. 

(of course we've also had a ton of drama about reliability of the numbers in my state - hiding deaths, firing the woman in charge of the dashboard, her claiming she was asked to falsify or hide info, etc)

[Arcadia]

We are looking at test positivity rate and hospitalization/ICU numbers and they are trending down for my county. So while total case numbers are high, the test positivity rate has drop continuously. 
 

DS15 went with us to Safeway supermarket after three weeks at home. He went with us to a nursery and Home Depot to pick out plants last weekend.
 

DS14 is a “hermit” now which is worrying since he had mild depression the last time he was a hermit. He hasn’t gone out of the house since March 14th. That’s 74 days of isolation so far. We might have to “forcefully” take him out for a car joyride this weekend.

[ktgrok]

3 minutes ago, happysmileylady said:

actual active cases in my area is totally a part of my overall risk assessment.   It's for sure a factor in figuring out how likely I am to actually be exposed myself and then potentially expose others.  When like 98% to 99.5% of the population isn't likely to be contagious....EVEN when using generous assumptions of asymptomatic/untested cases....the likelihood that I will encounter one of those people is extremely low.  Add to that the fact that the vast majority of my own encounters are brief, pass someone in the grocery store type encounters, and yeah, I figure the risk is low.  Even once our local pool opens, the likelihood that someone among the less than 400 total families that are members, will be infected, AND be there at the same time, AND be close enough to us, in outdoor air, and/or chlorinated water, again, extremely low....especially since about an hour is really all I can tolerate at the pool with my kids anyway lol.  

One problem I have is that Ohio isn't reporting recovered cases, that I have found.  So what I have had to do is, every so often, go into the actual spreadsheet, and then run the math on cases that are a month or more out.  So, sure, it's an estimate, but I think people still being infectious AND regularly being out and about is probably a super rare situation.

 

Yeah, we don't have that for the county, just the state, but I figure new cases per day gives me decent info. I tend to add it up for new cases per week, in my head. 

Low risk activities, that involve no close contact, I go and I mask. But socializing for any period of time is a no for me at this point, with about 200 new cases per week in my area, and going up. Especially since people are NOT masking like they were. 

I was considering taking the kids to home depot to get them out for the first time since this started, but then heard no one is really masking anymore, or allowing for 6 feet of distance, and I decided nope. Sigh. 

[TracyP]

I do use this to make personal decisions. I go to the store with very little concern and I have been getting together with family members. One gathering was held completely outside to protect a potentially high risk individual.

In my case, my county has had .06% of the county test positive, so the percent of current active cases is very small. I don't know where my line would be, but it is a number I will be watching to judge what my family will or won't feel comfortable doing.

[vonfirmath]

37 minutes ago, happysmileylady said:

actual active cases in my area is totally a part of my overall risk assessment.   It's for sure a factor in figuring out how likely I am to actually be exposed myself and then potentially expose others.  When like 98% to 99.5% of the population isn't likely to be contagious....EVEN when using generous assumptions of asymptomatic/untested cases....the likelihood that I will encounter one of those people is extremely low.  Add to that the fact that the vast majority of my own encounters are brief, pass someone in the grocery store type encounters, and yeah, I figure the risk is low.  Even once our local pool opens, the likelihood that someone among the less than 400 total families that are members, will be infected, AND be there at the same time, AND be close enough to us, in outdoor air, and/or chlorinated water, again, extremely low....especially since about an hour is really all I can tolerate at the pool with my kids anyway lol.  

One problem I have is that Ohio isn't reporting recovered cases, that I have found.  So what I have had to do is, every so often, go into the actual spreadsheet, and then run the math on cases that are a month or more out.  So, sure, it's an estimate, but I think people still being infectious AND regularly being out and about is probably a super rare situation.

 

It appears "recovered" on the Texas website is just estimated as well.

 

[cintinative]

1 hour ago, happysmileylady said:

Ohio has total cases broken down by county.  But then on the Ohio website is a downloadable spreadsheet that is easily sortable by age, county, positive test date, hospitalization date (if hospitalized) and date of death when the unfortunate happens.)  So, it takes some math to try to work out the percentages and such. And, as I said, a bit of estimation.  I estimate that if a case was tested positive over a month ago, it's most likely that the person has recovered.  I mean, not in all cases, but since in many cases, people recover in closer to two weeks (ish) then I figure a month is a good enough estimation to try to figure current active/contagious cases.  

 

I noticed there was an increase in hospitalizations and ICU admissions from yesterday to today. Do you know how to figure out what county these were from? I can't quite figure it out.

 

Edited May 27, 2020 by cintinative

[cintinative]

3 minutes ago, happysmileylady said:

This is the link to the Ohio dashboard.  You can click on each county and it will give you county totals.  If you know the county total over yesterday, then you can figure that daily increase

https://coronavirus.ohio.gov/wps/portal/gov/covid-19/dashboards

 

Yeah, I haven't been tracking our local three counties. I probably should have.  

On the topic of this thread, for us in Ohio, is that testing capacity is still pretty low. It's around 9.5K/day. Dr. Acton talked about it on Tuesday but there are multiple factors in play. The goal was to ramp up to 22K/day by this past Monday (I think??) but they could not achieve it due to multiple obstacles. So it's hard for me at times to know what to think of the testing numbers. I have several friends who likely had it and were never tested. One of them went to the ER three times and was never tested (she had no trouble breathing, severe headaches and fever were the issue).  So I am just wondering (out loud) how much testing is going on outside of the congregate settings like prisons and nursing homes. 

[maize]

I absolutely take my county statistics and trends into account in decision making. My county has reported a little over 400 cases total, with about 80% of those considered recovered. Our positive test rate is 2.5%, suggesting that a high percentage of active cases are in fact being tested and reported. Most of the cases that have been reported are in the southern portion of the county and we are in the north.

We are, with caution, resuming some activities--for example, my five older children are attending a tumbling class together. I was able to arrange for the coach to open a class just for them first thing in the morning when no one else is in the gym nor has been in the gym since the day before; coach and kids all wear masks. I am comfortable that the actual risk of contracting covid-19 under these specific conditions is minimal. Businesses need all the customers they can get so will accommodate whenever possible.

Edited May 27, 2020 by maize

[EmseB]

2 hours ago, EmseB said:

I have tried this, but numbers in my county spiked, but it was solely due to prison tests. So it's still hard to gage the relative risk.

As if they heard my complaint, today they have separated out the prisons.

[Susan in TX]

Our county (Dallas, TX) publishes a report every Tues. and Fri. with a breakdown of cases by city. I have been following the cases in our city closely since the end of March. I look at the week to week increase in cases to decide if it is safe to go out. I am waiting for a sustained decline in new cases. Also our county has a color-coded risk level so I am following that as well. So far we have been in the red zone which is "stay home, stay safe". There are four zones: red, orange, yellow, and green. They are using new cases as well as hospitalizations to determine what zone we are in.

Susan in TX

[Pen]

I am taking county numbers into account, and even more than that cases by zip code since our county is probably as big in area as some small states. 

Our state has added the social “bubble” group to its concepts, which I think may help as it did in NZ,  and I think that an outdoors only, reasonably distanced activity with another family (bike ride? Hike?) might be a way to start in a case like you describe. 

[Meriwether]

I watch the numbers. I was much more relaxed at my parents' home (we quarantined before traveling), because they hadn't had a positive test in weeks, and only had a few overall. A couple of surrounding counties hadn't had any cases. Our county spiked while I was gone, coming home we have been more careful. Cases are trending down here, but it isn't the same as my parents' rural county with no new cases at all.

[Meriwether]

Ohio people, did you ever hear how many of the asymptomatic prisoners went on to develop symptoms? I was going to try to look it up but haven't yet.

[Pawz4me]

1 hour ago, happysmileylady said:

Truth is, this sort of guesswork has always been part of medicine.  Often, what is listed as "complications of influenza" or "complications of cancer" or whatever, is really some  actual other cause.....blood clot caused stroke, heart attack after a particular test, etc etc.  

Agree. The cause of death that was listed for each of my parents was IMO incorrect. My father's official cause of death was a heart attack (myocardial infarction) but it was because decades of diabetes wreaked havoc on his body, and at 85 yo his heart couldn't take it any longer. So the acute cause of his death was listed. My mother's cause IMO should have been listed as injuries sustained in an auto accident (acute cause), but was instead listed as a chronic lung condition. Neither listing made any sense to me, but I'm pretty sure there's always been a LOT of fuzziness around causes of death. The scenario of the terminal cancer patient's death being listed as a Covid death is pretty much the same thing that happened with my father (acute cause versus chronic cause).

As far as the original question--Yes, I'm watching active cases. I actually started my own spreadsheet a few weeks ago so I could make better sense of where the numbers were headed. Right now I'm especially concerned with the neighboring county, where we do almost all of our shopping and where our medical providers are. Their numbers are going up much faster, and doubling at a much faster rate, than I feel comfortable with.

Edited May 27, 2020 by Pawz4me
their not there. sigh

[prairiewindmomma]

You asked how I use data to make decisions for my family.

My zip code is a hot spot (yay! 😞 ), our testing numbers are somewhat low, and a fair number of people are asymptomatic and not being tested....  so when dh goes out he assumes that he will be in an area in which someone will have been who was symptomatic.  He wears a mask, washes his hands, and only goes out for the things that he needs.  OTOH, we assume when we are outside and masked that we are relatively safe, so we also go walking, talk to the neighbors at a distance, and go into our tiny urban backyard to enjoy the sun unless our coughing neighbor's family is out. 

We're going to be at this for a long, long, long time.  It's totally ok to do things for your mental health.  Maybe it's time to sit out with the neighbors some evening from your relative driveways in talk?  I have friends who pull their cars into my driveway and sit and talk there and I talk from my doorway.  (They are good friends to do this for me!!)  Figure out what you need to do to get through this!

[Arcadia]

10 minutes ago, prairiewindmomma said:

 Maybe it's time to sit out with the neighbors some evening from your relative driveways in talk?  I have friends who pull their cars into my driveway and sit and talk there and I talk from my doorway.  (They are good friends to do this for me!!)  Figure out what you need to do to get through this!

My area is mainly apartments, with some townhomes and single family homes. The ground floor patio of an apartment block is usually larger (extend more outwards) than the upper floors’ patios. I have seen ground floor neighbors talk to upper floor neighbors while standing at their respective patios 🙂

Edited May 27, 2020 by Arcadia

[Miss Tick]

4 hours ago, JumpyTheFrog said:

We’ve had a total of about 1500 cases in my county. The state has started reporting numbers of recovered people in the state. They calculate this by assuming people are better after 14 days for mild cases, and by 28 days for those who are hospitalized (unless they die). Using this metric, my county has about the same number of active cases as it did a month ago, despite entering phase 1 several weeks ago and phase 2 last week. I know there may be a big spike in a week from Memorial Day. So it seems to me that as long as the doubling rate stays above 28 days, the number of active cases is holding steady, and at some number would actually be decreasing.

The kids have been amazingly cooperative, but we’ve been isolated since March 14, so we are feeling more frustrated each week. I’ve now reached the point, after avoiding stores and people for so long, that going to Home Depot to buy grass seed today felt like a treat. I haven’t had an in person conversation with anyone except family  this whole long longer than discussing the lack of zinc at the vitamin store with the clerk.

How would you use the above calculations to influence your decision making about what to begin allowing again for your family?

I can't answer your question, there are so many additional, personal factors like risk levels in your house and family, comfort level, impact if somebody does get sick, etc. I will say that we've been having the same discussion in our house, though. I told my family that if we don't see any local spike this week (second week after opening up based on...government gut feel?) Then I would let everybody get together with a friend - assuming friend's family is ok with that. The following week, same deal, hopefully with the same friend! At that point I will revaluate. This is a reasonable approach for us. I'll keep an eye on the country numbers and keep my ear to the ground I guess. There isn't any real guidance, but I don't know who could really provide guidance anyway.

[Joker]

I can’t go by county because I live just a few streets from the border of the county with our largest numbers. My county has about 1100 total cases but the one right next to me is at about 9400. 
 

We pretty much just go to the store once a week and occasionally go to a home improvement place. I do plan to go to a local bookstore tomorrow. Youngest wants to go so we’ll mask up and do it. 

I also do visit with my mom once a week. We all sit outside with plenty of distance between us. That visit really helps us all.

Edited May 28, 2020 by Joker

[Meriwether]

2 hours ago, happysmileylady said:

I haven't heard anything like this, and I won't lie....there's only so much I can calculate at any one time so...yeah, I haven't been working on those calculations. 

I thought it might be in the news. I know when they were first testing about 96% of positive cases were asymptomatic. It would mean pretty different things if 90% went on to develop symptoms as opposed to 20%.

[Farrar]

We are in a hot spot and it's impossible to completely distance because we're in a dense urban area.

We are going out, taking walks. We're now seeing friends outside only, keeping a large distance. We take masks everywhere we go and wear them walking on the street. They are required inside all stores. Most stores are not open here. I'm the only one going in stores regularly, though the kids have run in to pick up takeout a few times.

Nothing else is open so nothing else can be done anyway. I mean, could I find a sickeasy to go out to a bar or to eat? I guess. Or could I find an illegal place to get my haircut? Um, I guess. But I'm not going to. Museums and activities are all closed. We're thinking about getting a cabin for a few days this summer to get away. If we can, we'll do that.

I also feel frustrated, but I'm not going to go inside stores for fun shopping and I don't think activities should be on anyway. I have loosened up and am now just running errands when I need it. Still keeping my grocery shopping trips much more infrequent though. I'm trying to shake things up for us by finding new places to go and hang out outside - new walks, new stuff outside to see. It's helping a bit.

[EmseB]

16 minutes ago, Meriwether said:

I thought it might be in the news. I know when they were first testing about 96% of positive cases were asymptomatic. It would mean pretty different things if 90% went on to develop symptoms as opposed to 20%.

Another place to look for numbers like this would be trying to follow any news from the USS Teddy Roosevelt, although the average age of that population is 24, so they will have less deaths and severe cases than the general population. At one point they were reporting 60% asymptomatic positive tests.

[AmandaVT]

I keep an eye on the data- VT is down to anywhere between 0-5 cases/day, no deaths in 10 days and today was the first day the hospitals had 0 COVID patients. Our testing is up a lot too and we're starting to hit the testing milestones we're aiming for. 

Right now I'm comfortable going to stores as necessary, wearing a mask. Church is not opening any time soon. The public pools in my area are closed for the summer as are a number of summer camps. My son re-started tennis last week - his coach is running semi-private lessons with two kiddos at a time. I'm cautiously hopeful that we'll be in good shape until (if?) a second wave comes. 

[Bambam]

Our cases are increasing in our county - but most of that is due to the fact that this is more testing available. They don't publish hospitalization rates (which would be useful info).
However, I'm going out a little more. I'm wearing a mask, some others are wearing a mask, but it is becoming less common. Many here are still 100% against masks in general. 

The news about the lowered fatality rate (0.26%) has people here wanting to restart everything as normal right now. And I tend to favor carefully and thoughtfully getting back to our new 'regular', but due to the large percentage of nursing home deaths, we need to have a decent plan to try to protect them. 

[Jean in Newcastle]

1 minute ago, Bambam said:

Our cases are increasing in our county - but most of that is due to the fact that this is more testing available. They don't publish hospitalization rates (which would be useful info).
However, I'm going out a little more. I'm wearing a mask, some others are wearing a mask, but it is becoming less common. Many here are still 100% against masks in general. 

The news about the lowered fatality rate (0.26%) has people here wanting to restart everything as normal right now. And I tend to favor carefully and thoughtfully getting back to our new 'regular', but due to the large percentage of nursing home deaths, we need to have a decent plan to try to protect them. 

Our local news listed the fatality rate as 1.3% last night. I paid special attention because I had been seeing much lower numbers on here. I don’t know their source for the numbers but I have been super impressed at how objective they have been trying to be in giving factual information. I wonder if I can find out how they got that number?