August 1, 2020 - The Truth Will Set You Free
The Truth Will Set You Free
August 1, 2020
July was a terrible month by any measure. There were 49,678 cases in the month, more than all of the cases in March, April, May and June combined. There were 630 deaths, almost as many as May and June combined. On July 1, a total of 2,803 Alabamians had been admitted to hospitals with COVID; by the end of July, that number had increased to 10,521.
I am increasingly concerned that the growing obsession with daily case numbers, without considering the relationship to testing, presents an opportunity for political manipulation. To quote President Trump, “If we stop testing, we’d have fewer cases.” The truth is, of course, that you wouldn’t have fewer cases, but you would have fewer KNOWN cases. Unlike the President, I believe it’s better to know the truth than to not know it. If you know the truth, you can do something about it,
This point is illustrated by examining data for the last 3 weeks in July. Here is the relevant data:
Week of 7/17 - 12,219 confirmed cases; 12,579 cases (incl. 360 probables); 70,896 tests
Week of 7/24 - 12,254 confirmed cases; 12,914 total cases (incl. 660 probables); 65,863 tests
Week of 7/31 - 10,913 confirmed cases; 11,718 total cases (incl. 805 probables); 60,480 tests
As you can see, confirmed cases declined by 10.7% over the two-week period from 7/17 to 7/31. Total cases declined (including probables) declined by only 6.8% because the number of “probable” cases more than doubled over the same period. Meanwhile, weekly tests declined by 14.6%. In other words, tests declined at twice the rate that cases declined.
Remember - the only difference between a “confirmed” case and a “probable” case is the absence of a confirmatory test. A probable case exhibits all the symptoms of COVID and was in close physical proximity of a confirmed case. So, why do most probables lack a confirmatory test? Could it have something to do with the 7-10 day delay in getting test results? The answer should be obvious.
The most important metric, which takes into account the relationship between cases and tests, is the positivity rate. According to Johns Hopkins, the 7-day positivity rate for Alabama on 7/17 was 17.75%; on 7/24 it was 19.61%; and on 7/31 it was 19.37%. This means that the virus is spreading at a faster rate now than it was two weeks ago even though the raw number of cases has declined.
Now, we begin a new month and it is more of the same - 1,646 cases (incl.124 probables) and 23 deaths (incl. 1 probable). There were 7,780 tests, which caused the 7-day average to drop to 7,858 - a huge decline from the peak of 11,932 on July 15. Accordingly, our 7-day average positivity rate rose to 20.2%. As of yesterday, only Mississippi (21.3%) had a higher 7-day positivity rate than Alabama and we may be closing in on our neighbor to the west. The 14-day totals:
7/19 - 1,777
7/20 - 1,880
7/21 - 1,467
7/22 - 1,455
7/23 - 2,399
7/24 - 1,793
7/25 - 2,125
7/26 - 1,164
7/27 - 1,821
7/28 - 1,251
7/29 - 1,416
7/30 - 1,980
7/31 - 1,961
8/1 - 1,646
Mobile set a new record with 382 cases and Jefferson was next with 271.