Fear The Chorizo

One thing that is frustrating about trying to tie daily death tallies to recent testing surges is that there are plenty of newly reported deaths that are incredibly backdated due to lags in death certificate/coroner reporting...many deaths being reported in early July related to COVID actually occurred weeks, if not months ago. We'll have a hard time making sense of the end result of the current case surge among younger people in terms of deaths until we get into August, most likely. Related to schools, no in person school in the fall should come with the necessary measure of furloughing a vast majority of school teacher/staff/administrators for the sake of trying to maintain budget sanity for all the economic damage not having in person school would lead to. How the hell is an elementary school kid in the heart of Chicago going to get any sort of education (maybe a bad example, as unfortunately they likely were getting crummy schooling to begin with)? There were huge percentages of kids across the country in urban and rural areas who never even logged into their e-learning accounts once after schools were shut down last spring. How is any elementary school aged child going to be successful heading to a new grade with a different teacher that doesn't get an opportunity to learn who they are in person? Talk about an achievement gap... There is plenty of evidence pointing to children, especially the little kids who are walking disease distributors, not possessing the viral load capacity to readily transmit COVID-19 to adults. Most of Europe has had schools open for months, even if at a limited capacity or schedule. Elementary and middle schools absolutely need to be open this fall. Colleges and perhaps high schools can continue operating haphazardly through the internet, but that approach has no chance of working well with young children in households where parents need to work or in households that are ill-equipped for e-learning no matter what the districts try to provide. Not picking a side here, being a teacher, I still am on the fence, but if you think kids are not socializing with other kids, drive around a little bit. They are everyplace. Big kids, little kids, kids of all ages are with each other socially. That's commonly referred to as summer break this time of year. There's alot to be said about interacting socially in a school setting, too instead of being shuttered inside their house glued to an Ipad trying to plug an assignment into the Seesaw app - school settings give kids the opportunity to get acquainted with others who don't live in their neighborhood or are hand-picked by their parents to associate with. Seeing kids congregating in public now also should point to the fact that sending that same pack of children back to school shouldn't be viewed as any higher risk than what they've been up to socially for months - I'm sure there are teachers/admins/janitors that are indeed high risk and have yet to leave their home or interact with anyone closer than 6' from them...for those people certain measures definitely need to be enacted to protect them. Completely shutting in person school systems down should not be one of those options. I'd much rather pay them their salary to stay home and find ways to support their classes' curriculum remotely while their class is actually present in school. And don't mistake the fact there are many more teachers who have been out and about since March and really do want to get back doing what they love doing in a classroom setting.

Pretty sure this means asymptomatic Gallo is counting as 2 confirmed COVID 19 cases in TX or wherever he's currently living (Vegas??).

Keep in mind the initial significant outbreak occurred across Europe roughly 3-4 weeks before it happened in the US. Probably splitting hairs - I'd state that peak US outbreak from a deaths perspective was mid-late April and peak specifically for Italy was late March...although it's tough looking at individual European countries compared to the US as a whole because of both population and geography. From what I recall Italy led the way in terms of it being Europe's initial ground zero, but then Spain and Belgium/France weren't far behind them followed by Britain. Once it was apparent all the travel ban nonsense wasn't enacted quickly enough from Europe at the end of February, there was no stopping it popping up across the US. Not really. I was tracking it in late February and early March with my AP Human Geography class. The epicenter of Europe was Italy, and we were statistically about 10 days behind them. Probably splitting hairs but you're most likely correct - for some reason I recall Italy getting bad sooner than that in terms of concerns with hospital capacity, not necessarily daily death tallies which Italy had initial trouble getting accurate numbers out due to their system being overwhelmed. I'd state that peak US outbreak from a deaths perspective was mid-late April and peak specifically for Italy was late March...although it's tough looking at individual European countries compared to the US as a whole because of both population and geography. From what I recall Italy led the way in terms of it being Europe's initial ground zero, but then Spain and Belgium/France weren't far behind them followed by Britain - with those countries paralleling NY/NJ's progression. Once it was apparent all the travel ban nonsense wasn't enacted quickly enough from Europe at the end of February, there was no stopping it popping up across the US - particularly in the primary travel hubs to/from Europe.

Keep in mind the initial significant outbreak occurred across Europe roughly 3-4 weeks before it happened in the US. So their daily death tallies on a per capita basis right now would reflect where the US may be in a month's time. Also keep in mind the testing per 1,000 people was 1.92 in the US in early July - for Germany (Europe's gold standard for high volume testing) it's roughly 0.8 and for France, well they stopped really testing significantly at the end of April when they were around 0.23 tests/thousand - or at least providing testing data consistently since then. Factor in how differently various countries/regions report COVID deaths/hospitalizations/cases, and it's really easy to see how pointless it is trying to compare any of these datasets that are so dissimilarly constructed. Despite all that, the overall US death curve is trending similarly to that of the European continent's curve, just that it's lagging by a few weeks. What will be very interesting is seeing whether a second spike in actual COVID-related deaths crops up in the US that mirrors this surge in cases - with the prolonged increase to hospitalizations in several states one would think we'd be seeing that by now, but it hasn't really materialized. I'd also caution looking at specific daily US death tallies for this whole week and let the rolling averages level things out before making an educated guess - the 3 day holiday weekend is going to play games with reporting schedules...my gut tells me we won't necessarily see a big increase in nationwide deaths, but we'll see a prolonged length of several hundred daily deaths before it bottoms further out as other metro areas work their way through hot spots and surges - but without throwing infected patients back into nursing homes. New York state was seeing close to 750 people die per day with COVID-19 complications back in early April. I also think this perceived spike in cases across the US has more to do with the fact the confirmed cases from the initial spike in places like New York, Chicago, Boston, and other metro areas we observed back in March/April was many times less than actual infections due to a fraction of the testing being conducted. Europe has essentially discounted the value of PCR testing more of their population as their death rate has gradually declined and as they have reopened things. The US continues to increase testing - particularly PCR "snapshot" COVID-19 tests...that's fine, but I'd really wish they and the rest of the world shift into more of an antibody testing program to track the percentage of people who have already gotten infected and processed the virus. Right now there's probably limited appetite from a pharmaceutical standpoint for that data, as increasing evidence of herd immunity winning the race against an initial vaccine that "might" be 50% effective and a virus that appears to be weakening in terms of symtpoms/lethality over time could render a large scale vaccine push pointless from a global health perspective. Even if that's the case, there's value in developing a vaccine for coronavirus all the way through compared to what they did with SARS - doing so at minimum gives scientists a better jumping off point for the next similar virus.

Hasn't this pretty much been known for months by now? One other item of note related to masks, as google has done a masterful job of slapping a bunch of ads on pages I've been on related to buying masks - if you see anyone walking around with any type of face covering that has those one-way filter valves built in, run away from them faster than people with no mask at all. Those one way valves filter air that person is breathing in, but almost all of those filters aren't tight enough to prevent aerosols and other fine particles viruses may be latched onto from being inhaled. Then those same valves serve as concentrated exhaust ports for exhaled air/mist/droplets/etc that get spewed much farther out than someone just normally breathing from an unobstructed mouth or nose. For a general contractor working on a drywall project that doesn't want to inhale potential asbestos-containing material or other dust, they work great. For John Doe waltzing through the general public with a false sense of security, they turn him into a superspreader.

Fever or chills Cough Shortness of breath or difficulty breathing Fatigue Muscle or body aches Headache New loss of taste or smell Sore throat Congestion or runny nose Nausea or vomiting Diarrhea These are the current list of COVID symptoms...I can check at least 3 of these off daily depending on what mood my kiddos are in;). Right now if a person wants or needs to get tested, they can get tested if they do even a little digging no matter what state they live in. It's also not very difficult to drum up a "potential exposure" situation either - and anecdotally I know my company has had back to work testing requirements for employees performing work at jobsites that requires out of town travel or potential exposures to either individuals or locations that knowingly had COVID. I've been tested 5 times myself since early May and they were entirely due to work-related project requirements.

Or its those same kids needing to be tested for summer jobs at bars/restaurants/service companies that have personal interaction with clientele, or contact tracing actually prompted them to get tested - exhibiting symptoms is no longer a requirement for getting tested for COVID for anyone, including youngsters.

Tons to unpack in this tweet thread below and I don't necessarily agree with all points attempted to be made...but pretty interesting nonetheless when looking for reasons/factors for case spikes and hospitalizations climbing among COVID-infected people in the US. https://threadreaderapp.com/thread/1276494896132534277.html

Our trends and comps to Europe look so much worse though, no way around that data I can come up with. Look at confirmed case fatality rate - the US sits between Liberia and Indonesia, 31st in the world despite having by far the most confirmed COVID-related deaths. European nations are all over the top 10-20 countries in that stat, because aside from Germany they really haven't widely expanded their testing to the degree the United States has. The case count spike seen in parts of the US is tied directly to testing people 50 yrs and under as part of a widescale return to work initiative over the past month-6 weeks. With the exception of Germany, european countries really haven't embarked on wide scale testing for their younger populations, particularly on a per capita basis. It's easy to keep case counts from spiking when you don't bother testing...Austria sure has it down https://news.yahoo.com/almost-half-virus-hit-austria-ski-resort-antibodies-165114333.html

Doesn't this require the assumption that that liver transplant patient wouldn't be at a high risk of COVID complications/ICU needs because of that very underlying condition? Potentially, but if you're an alcoholic who needs a new liver and the only reason you became aware you have COVID is because the hospital tested you for it prior to a procedure, I wouldn't consider them any higher risk of requiring an ICU bed than if they tested negative for COVID. A liver transplant, heart surgery, other major procedure patient is going to require an ICU bed no matter what - if they are an asymptomatic positive COVID case they likely take up a bed in a portion of the hospital established for COVID patients to reduce spread. They aren't in ICU because of COVID, they are recovering from a major surgery. I really doubt hospitals are seeing a swell of patients showing up that can't taste anything and undergoing respiratory failure requiring intubation and doctors are saying "hey, while you're in here recovering from from the 'Ro' we realized you need a bunch of new organs, so let's get that taken care of, too." But wasn't the narrative just a couple of weeks ago that the 'peak' in states like Minnesota happened around Memorial Day? Clearly, that wasn't actually the case and it has proven false, much like the hopes that were pinned to the 'wait until the weather gets warm' narrative as well, which was extremely prevalent back in early spring. The point is, regardless of what the cause is, the virus HASN'T slowed down in the summer, and cases are ballooning, and it absolutely has to do with the lessening of restrictions. During the extended lockdown, MN health officials figured the peak in the state would be late June or into July assuming stay at home measures continued through most of May. They started lifting restrictions in mid to late May, then the George Floyd issue happened right as hospitalizations/new cases were climbing in late May and many said the state was headed for disaster since the true peak hadn't yet hit. Today, a full month after protests and rioting were occurring, the state reported 5 new deaths with a hospitalization total similar to early April when the initial wave was just starting to climb despite a ton of tests. I fully expect MN cases to climb again later this summer just like everywhere else because testing numbers is what is driving case counts. Based on both hospitalization and death rates compared to case counts, the virus has indeed slowed down in terms of its impact on people's health - if its a diminished virus it doesn't kill as many people as it did months ago...that's a very common occurrence with viruses as they mutate/evolve.

Sorry for the lag in responding, but yes...this is happening - but the reality in climbing ICU capacity in states like AZ is definitely of concern, as it's a combination of "normal" hospital function but also trying to accomodate the added stress COVID patients requiring substantial hospital care. I just hope when the liver transplant patient is notified about having COVID, they are kindly reminded they are an asymptomatic case and wouldn't ever need to be in a hospital for it for their own peace of mind...IMO needing a new liver sucks way worse! However, a patient in a hospital for a liver surgery that happens to have asymptomatic COVID is logged as a COVID hospitalization until they get discharged - as it's likely they would need to recover in a COVID-specific section of the hospital because they are potentially infectious despite being asymptomatic.

I don't think it has a whole lot to do with if/when states unwound restrictions on businesses/activities that aren't obvious large indoor crowd gathering events. Even states that never shut down imposed and continue to impose strict social distancing measures and don't have huge community events going on. If statewide business reopening policy was more prevalent then California wouldn't be exploding in their daily case totals, WI would be going nuts, etc. This recent surge in certain states seems to have alot more to do with areas requiring heavy AC use for common life - i.e., people staying indoors breathing largely recycled air rather than mostly fresh air. Summer weather doesn't do people much good if it drives them inside more. Nationwide, the average age of confirmed cases is also plummeting due in large part to working age demographic testing increases. There are a ton of employers requiring testing before going back to work. These people were likely getting infected 2 months ago, they just weren't being tested on a community-wide scale because they weren't symptomatic and testing elderly/at risk demographics was far more important. The last thing I'd add to this is even with the shutdowns, there was going to be a time a few months after they ended when the virus would "peak" - many times that peak was forecast to be in June/July even with stay at home measures. We are basically at that point on the calendar, so it's not exactly a surprise that other parts of the country appear to be "peaking" regardless of what they did back in April or May. Stay at home wasn't intended to eliminate the spread, it was intended to get areas to a place medically where they could manage care through its inevitable outbreak and not have the entire country in flames at the same time. Also, there's growing anecdotal evidence that both positive test count and infection rate parameters aren't closely tied to individual cases to the point of accurately projecting COVID-specific hospitalizations and most importantly COVID-linked deaths - especially if trying to use the rates initially established this spring while using results of very limited to no population-wide testing. Hospitals test patients multiple times, especially if a person tests positive initially. How various states report these totals from hospital systems and labs is not entirely consistent in both information sources and timing of how data is reported/tallied on a daily basis - that helps to explain some of the discrepancies with ICU/hospital bed use/hospital discharges/specific dates of COVID-related deaths, etc.

These are pretty much the same choices every single other working age person needs to make going about their daily life. I get the pregnant wife concerns, but how many MLB players live and care for their elderly parents during the baseball season? Pretty sure that's a bigger concern for alot more nurses and people working at amazon fulfillment hubs.

It's tough to really pin down what a "normal" hospital/ICU bed usage rate is prior to COVID-19 in the US because it does vary seasonally and from year to year, but conventional wisdom has that percentage hovering around 75%. If hospital bed capacity is far lower than that for too long, the hospital system suffers because it isn't making enough money with surgeries or procedures that require hospital bed use/equipment and staff to administer care to those patients - and medical costs as a whole increase to make up for lost revenue from too many empty beds. As hospital systems have gradually reopened for conducting non-COVID19 related procedures, we're now seeing concern about hospital bed capacities from people tracking daily tallies similarly to how they were tracking them in late March, but that data isn't being fully put into the context of what it means in late June. As far as I can tell, none of these apparent hot spot states with shrinking hospital system capacity are urgently requesting military/field hospitals be constructed, or even putting wheels into motion to get their untapped surge ICU bed capacities dusted off for use. This is in large part due to many of these COVID-19 hospitalization patients not showing up at hospitals with just COVID-19 symptoms requiring intubation - there are a large number of patients coming in for other surgeries, childbirths, other critical care that were set to take up a hospital bed for a few days anyways. These people are all tested (in part for infection safety but at this point equally for financial purposes), and a decent chunk have become COVID-19 positive cases who also are logged as hospitalizations even though they're not symptomatic. Arizona is presently one of these apparent alarm bell states, which happens to have roughly 80-85% of its beds in use, both from a general hospital bed and ICU bed capacity. In a vacuum that number is indeed alarming, especially considering how many snowbirds may be spending the summer down there because it was difficult for them to travel back north. However digging more into AZ's numbers, the state still has roughly 60% of its ventilator capacity available and plenty of emergency department bed capacity. Also, daily COVID19 hospitalization discharges are spiking right along with the increases in both daily overall and COVID19-positive hospitalizations while COVID-related deaths are holding steady or even declining - indicative of patients who were admitted to a hospital for something other than COVID19 who tested positive for the virus while taking up a hospital bed until they were discharged a few days later because they were asymptomatic or simply didn't require continued hospitalization due to the virus. I'm not saying AZ's numbers aren't worth watching closely in the coming weeks and months, but there's alot more to the data being looked at than what is being reported by those who are chasing where the 'next New York' is going to happen. Frankly, hospitalizations specific to COVID19 symptoms should be closely tracked everywhere - however the growing disconnect between case counts and the percentage of cases that require hospitalization entirely due to COVID19 symptoms needs to be better explained to the general public. Otherwise there will continue to be unnecessary panic every time a hospital system has more than 3/4 of its beds occupied. The steady rise of hospital bed use, including ICU bed use, is part of the medical system getting back to its business and the country as a whole maintaining its overall health due to all things non-COVID.

I went to the Dr.'s office Friday, and just in my 5 minutes waiting to check in I saw one person wearing a mask that didn't cover her nose, and and older lady who pulled the mask down every time she talked to the people around her. Seriously. It may not be rocket science, but there's clearly a lot of people below that on the learning curve that still don't get it... And we expect elementary school kids to wear masks properly... It's the people who can't wear it properly, people who have worn the same one since march without washing it, and the people who wear it for Instagram post virtue signaling and gain a false sense of security for themselves that stand a far better chance of getting infected and infecting others than people who dont wear a mask but are much more cognizant of social distancing measures. All people who opt not to wear masks are not cretans, just like all people who do wear them arent doing it for their concern of others.

On the players side, this has alot to do with the fact they feel they and Tony Clark got owned in the last CBA negotiation, and they are adamant about looking like they get the better end of this round. The failure they have in public perception and with this approach now is this shortened season due to a pandemic shouldn't be like a CBA negotiation to get back on the field. They should have kept their powder dry for next offseason. Instead now they come out looking greedy going after a higher chunk of severely diminished league revenues this year and blew their position for next year's actual CBA negotiation - when getting even small concessions from owners next year would drastically improve their pocketbooks in the longterm. The owners are likely to just tell Manfred to shut it down for 2020 very soon, I'm sure there are a handful that have already been telling Manfred as much.

Nice strawman you erected there. Everybody says they fear the protests will lead to an uptick at the very least. Literally nobody has said the protests are perfectly safe I hope everyone understands that nothing is 'perfectly' safe, COVID or no COVID. The previous poster didn't write 'perfectly' safe related to the protests, so that 'literally nobody' actually includes the poster you were responding to. Fearing protests will lead to an uptick in case counts is fine - to me that's been a more reasonable concern than alot of the other activities the general public has been restricted doing over the past few months considering how disproportionate serious cases both outside and inside of long term care facilities were impacting lower income and minority communities in urban areas. However, that fear also doesn't appear to align with reality - at least following the initial 'wait 2-3 weeks' period...it also fails to consider the fact that protests and riots saw a very limited number of nursing home patients taking to the streets. While MN still lags compared to many of its peers, results of increased testing and protective measures for long term care facility patients over the past month have appeared show up in the statewide hospitalization/death data. Why those measures weren't in place back in mid-March will always be beyond my comprehension. https://www.mprnews.org/story/2020/06/15/latest-on-covid19-in-mn It's been 3 full weeks since George Floyd was murdered in Minneapolis, and well over two weeks since there were nightly large protests/demonstrations, plus looting and rioting. The state offered and urged free COVID testing to anyone who participated in the events leading to crowds, regardless of whether they were showing symptoms or not. Despite the increases in testing, unchecked large gatherings during these demonstrations, and expanded reopenings to society since mid May in this state, there has been a steady decline in daily case counts over the past 1-2 weeks here and a more marked decline in COVID-related deaths and COVID-causing hospitalizations for a bit longer. Across the country, case count totals will ebb and flow across the general population because they are largely driven by how many people get tested and where those tests are focused - but yesterday the daily number of nationwide COVID-related deaths reported was the lowest number it's been in about 3 months...and a decent number of those deaths will get backdated to when they actually occurred. Daily reporting is weird, especially with weekends, but the week to week mortality trend has been pointed steadily down since late April despite total case counts going up or holding steady for quite a bit longer due primarily to increased testing. Back in Mid May, the U of Minn's updated COVID model projected there would be around 1,700 minnesotans who would die from COVID complications by the end of May based on revised parameters and forecasts...that was with the state at roughly 700 deaths at the time and it was the starting point for that model. Right now MN has ~1,300 COVID-related deaths and we are midway into June, and the rate we are going right now 1,700 deaths won't happen here until after 4th of July, probably longer out than that. The best information they had couldn't get them even in the ballpark projecting deaths over a 2 week period, and there's pretty much no way they can say it's because MN did a good job of social distancing, even before George Floyd's murder. This time of June was supposed to be MN's peak based on all the other measures they had initially put into place and have slowly lifted, but the peak hospitalization/mortality period appears to have been the end of May.

There arent profits to be had this season across the board for mlb teams, because there isnt a true revenue sharing model for the actual revenue streams they have to draw from. Argue it's a way for mlb teams to curb financial operating losses, sure. But dont state it's about maximizing profits for all 30 teams.

It's almost like the owners have a very good idea what the actual revenue stream they will have to work with this year with no ticket/gate income and the real possibility of limited gameday revenues in future years, and the players dont. If this is true, I'm sure the Owners would have zero issue with opening their books to share with the Players so a deal could get done in short order. Oh wait... What is the point in opening up books based on prior seasons that included full stadiums and gate revenues to make a deal this year? That would be all about leverage for next year's CBA negotiation, which is exactly what this farce of a back and forth between players and owners is right now.

It's almost like the owners have a very good idea what the actual revenue stream they will have to work with this year with no ticket/gate income and the real possibility of limited gameday revenues in future years, and the players dont.

They still account for roughly 40% of them, for some people that's just about half. It's 37%. That's some serious rounding if you think it's close to half. On May 1st, it was 48% Ok - 37% is still pretty darn significant when the overall number of cases is now over 2 million when back on May 1 it was only 1 million. I'm not really sure why it's a surprise that two states totaling under 10% of the entire US population are seeing a diminishing share of nationwide COVID cases as time elapses and the virus continues its inevitable spread, but whatever. The other thing to keep in mind with hospitalization rates is basically every person now going to a hospital for an elective medical procedure or surgery is being tested whether they are symptomatic or not - positive test results deem those people COVID-19 patients that are hospitalized...even if the reason for hospitalization has nothing to do with symptoms related to COVID-19. Even for the perceived current hot spot states, they are nowhere close to what NY/NJ was facing as a medical system strain back in early March when it became obvious they had no idea how widespread COVID-19 was in their major urban areas.

Feels like it wasn't that long ago that NY and NJ accounted for just about half the deaths. They still account for roughly 40% of them, for some people that's just about half. Add in Massachusetts, Connecticut, Pennsylvania, Delaware, and Maryland (states with urban centers that are in the same geographical area), and they account for roughly 56% of US deaths but 42% of overall confirmed cases. Over the past few weeks daily case counts are climbing at a faster rate than death/hospitalization rates - in large part due to increasing testing particularly among younger/healthier population groups than who the majority of testing was conducted on during March/early April. Likely outcome of a confirmed case in mid June is far different than what a confirmed case in March was, because a much larger percentage of testing is being performed on people who aren't yet symptomatic or already in the hospital with a respiratory illness. The virus was likely spreading among the younger/healthier populations at a similar rate in March/April then it is now, it's just that those people weren't tested nearly as frequently a couple months ago to confirm they had the disease. And some of these climbing confirmed case totals in states are due to antibody tests that have been available to the public since around mid-May - those results may lead to a confirmed case but most just confirm the person had Covid-19 at some point earlier. A positive antibody serum test typically doesn't result in a trip to the ICU for that patient.

A lot of 2-month Christmas breaks in your neck of the woods? As long as they extend the rest of the in-person school year into July to make up for the lag in returning, why not? If that's a problem, then everyone should stick to the normal break. Why two months? Why not 6 weeks or 5 months? Do people really need that much extra time to online shop for gifts?

Sorry if my initial post wasn't clear- I'm 100% certain school will be back in session in the fall. I'm also quite confident there will be another complete closing sometime around the holidays. I believe that is commonly referred to as Christmas break...

So when is it ok for fans to be back in the stands, in your opinion? I'm not saying today is the right answer or never is the right answer, I'm just curious what current opinions are. Keep in mind stating opening day 2021 has zero evidence it would be any lower or higher risk than letting people back in the stands right now, and continuing to try and play games without gameday ticket and gate revenues in the midterm would lead to professional sports leagues ceasing to exist? Professional sports REALLY IS all about money...playing without fans destroys their revenue model and makes professional sports immensely less lucrative for all parties - owners and players.