Vaccines are changing the way we interpret COVID-19 numbers


It has never been possible to know for sure how many people in the United States are sick with COVID-19 at any one time. Instead, we combine all the metrics – the percentage of tests performed that are positive, the number of new cases reported each day, the people who come to the emergency room sick with COVID-19 symptoms) to get an estimate. It’s like the story of the blind man and the elephant: experts can feel the different pieces of information to get an idea of ​​what an outbreak looks like, even when they can’t see it directly.

We have seen the same elephant emerge over and over again in the past year. First, increase the percentage of tests that are positive. After a slight delay, hospitalizations start to increase and then deaths. But this time, there is a new wrinkle: vaccines. That will change the pattern and make COVID-19 trends over the next several weeks and months more difficult to interpret.

One of the most important data points for tracking the spread of the virus has been the number of people hospitalized with a COVID-19-like illness at any given time. It is a concrete metric. If someone is so sick that they need to be hospitalized, they are usually in the hospital. Other measures, such as the case rate and the test positivity rate, are delicate; They fluctuate based on the number of people who decide to get tested.

“Hospitalizations are our harsh result. Everything else is so heavily dependent on testing, ”says Melissa McPheeters, co-director of the Center for Improving Public Health through Informatics at Vanderbilt University. That’s why we’ve looked at hospitalization trends to get an idea of ​​the direction of the pandemic, even when case rates are staggering.

Now, COVID-19 cases are starting to rise again in the United States. But this time, more than 70 percent of people 65 and older in the United States have received a first dose of the COVID-19 vaccine. That is the group that, if they contract the virus, are more likely to be hospitalized or die. They are now vaccinated and their risk of hospitalization and death is incredibly small.

That could throw off our normal data patterns. Cases could increase because many states are relaxing restrictions while most people are not yet vaccinated. But unvaccinated people who do get sick may be younger and less likely to be hospitalized.

Our normal method of visualizing the elephant would no longer work. It’s a good problem to have: fewer people in the hospital is a wonderful victory. But when case numbers falter and tests rise and fall, hospitalizations will no longer be a reliable backup to clarify what is happening with the pandemic. “I don’t know if we can get that good of a sample of what’s going on in the community,” says McPheeters.

It could mean that we need to recalibrate how we monitor the pandemic. There may be fewer people in the hospital, but we could take a closer look at that group, for example. If many people from one area of ​​a city are in the hospital, or people who work in a similar industry, that could be a sign that there are more viruses in that particular community, which could help people determine their risk. and show officials where to direct resources. “It’s not just about how many people, who it’s ending up in the hospital, ”says McPheeters.

For the past year, people have analyzed COVID-19 metrics to guide decisions about how they should behave, whether it’s sending kids to school, meeting up with a few friends, or getting groceries delivered. Eventually, as more people get vaccinated, new patterns could begin to emerge that could guide that analysis. And when the pandemic begins to fade, we won’t have to analyze the COVID-19 numbers so closely. But for now, everything is changing and we cannot assume that a number means the same today as it did in January.

This is what happened this week.

Investigate

Covid code unlock
Dive into the world of genetic sequencing and explore how this tool could change public health in a post-pandemic world. (Jon Gertner / The New York Times)

No one can find the animal that gave people COVID-19
The groups are searching for the animal that first transmitted the virus that causes COVID-19 to humans, starting the pandemic. It is not an easy task and international politics makes it much more difficult. (Anthony Regalado / MIT technical review)

Developing

The Wild Ride by AstraZeneca
On Monday, AstraZeneca announced that its vaccine was 79 percent effective. The next day, the government issued an incredibly unusual public reprimand against the company, saying those figures were out of date. AstraZeneca released new numbers later this week and found that it was actually 76 percent effective. Phew. In the end, it is a pretty good vaccine with a bad communication problem. The FDA committee hearings for this will be interesting. (Nicole Wetsman / The edge)

Pfizer begins testing its vaccine in young children
Children under the age of 12 are beginning to participate in COVID-19 vaccine clinical trials. Pfizer and Moderna are beginning their own trials to test how well the vaccines work in younger patients and if they are safe. (Apoorva Mandavilli / The New York Times)


Here’s a great video from our colleagues at Vox explaining the differences between vaccine efficacy numbers.

Perspectives

There were the two weeks in the summer when all I could smell was phantom smoke. The smell was so strong that one morning she woke up with a start, convinced that something in her house was on fire. Some time later, she could smell her boyfriend’s cologne again, but instead of the familiar scent she had always loved, it was a disgusting chemical smell. There’s also the hand soap at work, which used to smell generically fruity to her, but now smells exactly, and eerily, like Burger King Whoppers.

– Sarah Zhang writes about Ruby Martinez’s experience regaining her sense of smell after COVID-19 at The Atlantic.

As of December 10, my health care plan had billed me $ 536,000. My plan paid for most of it, but I still owe around $ 150,000. That does not include my bill for the implant. Medical bills are late; It takes months for things to work out. At first, it was stressful for me to watch them, but now it’s a joke. I look at them and think, I don’t know how to pay for that. My premium is $ 750 a month and my co-workers have contributed to cover it.

– Liza Fisher tells journalist Wudan Yan about the costs of COVID-19 in a story for Intelligencer.

More than numbers

To the more than 505 million people who have been vaccinated, thank you.

For the more than 125,864,307 people worldwide who have tested positive, may your road to recovery be smooth.

To the families and friends of the 2,761,409 people who have died around the world, 547,756 of those living in the United States, their loved ones have not been forgotten.

Stay safe, everyone.

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