After spending the better part of the past two days sifting through mountains of available data – not all of it consistent – there’s a LOT of good news out there, with a little bit of bad. The worst of the bad news is that to make sure things start trending in the right direction (which they will at some point), we’re going to have to remain isolated from one another for a little while longer. Here’s what we found:
SURGE IN CASES CORRESPONDS TO SURGE IN TESTING
A significant spike in COVID-19 cases this week occured not because of a sudden increase in infections, but because of a significant surge in new testing. Over the past three days, Florida tested more people (13,493 between March 25-27) than we tested in the previous three weeks combined (12,865 from March 1-23). And of course, we got a surge in positive cases to go with it.
“If you go back and look where we were just a week and a half ago, the number of tests that were being done a day, to where we are now, that’s a huge sea change…so some of this is just identifying what’s already been out there.” –Gov. Ron DeSantis, March 27th, 2020
The good news is that the percentage of positive cases (10%) remains fairly consistent, despite the surge, indicating that most of the growth in new cases we’re seeing can be directly attributable to the number of new tests.
Here’s a chart to visualize the data:
The state’s own ramped up testing wasn’t the only contributing factor, either, according to Florida Surgeon General Scott Rivkees. Part of the massive spike is attributable to a backlog of cases being dumped to the Florida Department of Health by a private lab, which sent 4,000 patient test results to the state on Wednesday night.
WHAT TO WATCH FOR: Keep a sharp eye on the rate of positive COVID-19 tests. Miami-Dade County, with 27% of all COVID-19 cases in the state, also has the highest percentage of positive test results, at around 14 percent of all tests coming back positive. Leon County, by contrast, has a rate of just 4 percent positive. Statewide, we’re seeing about 9 percent positive. Theoretically, that rate should start going up as the number of cases increases.
THE ONLY STATISTIC THAT REALLY MATTERS
The sole reason that 21.3 million Floridians have spent the past two weeks hunkered down at home, guarding their toilet paper stash and trying to cope with increasingly bored kids isn’t because we’re trying not to get coronavirus. Chances are, most of us will eventually get it, just as most of us also get the flu or common cold. No, the real reason we’re social distancing is because we’re trying to prevent our health care systems from becoming overwhelmed with COVID-19 patients. And in the end, that’s the only thing that matters.
HOSPITAL MATH: Depending on the data source, Florida has anywhere between 45,000-52,000 total hospital beds, of which about 15,000-20,000 beds are unoccupied and available at any given point in time. We also have a couple thousand intensive care unit (ICU) beds which will be critical for coronavirus patients with the most serious symptoms.
In a press conference, Governor DeSantis announced that as of today, three weeks into the outbreak, we have exactly 503 people hospitalized in the state with COVID-19, and we still have more than 19,000 beds available. That means we still have about 98-99 percent of our hospital capacity left. Yes, that’s a lot, but it can evaporate quickly because of the exponential growth of hospitalizations that we’re starting to see.
There is also a lot of evidence that most hospitals around the state are currently seeing a surprisingly low volume of patients. In many cases, nurses have seen their hours reduced, and ER wait times around the state remain incredibly low – likely because people are staying home, taking fewer risks, engaging in less dangerous activities, and avoiding social contact which has a large impact on the number illnesses and injuries our hospitals usually deal with.
WHAT TO WATCH FOR: As I’ve said, the number of COVID-19 hospitalizations is the only metric that really matters in this crisis.You can ignore everything else because non-hospitalized COVID-19 cases are largely irrelevant but for the new people they infect, which in turn, aren’t relevant either, unless they are hospitalized.
Keep a sharp eye on the hospitalization number (available from the state health department here, in red) and compare it with previous days to understand how fast it’s growing. Don’t worry, if you don’t have the previous day’s data, we’ll keep track of it for you – check out the chart below.
THE BAD NEWS: Despite the reduced number of overall hospitalizations, the past nine days have seen COVID-19 hospitalization numbers double twice, and we’ve added 50 percent of that total in just the last three days. Deaths have also started to grow quickly:
At our current rate of exponential growth, we can sustain only five more doublings before we hit the limit in terms of patients we can treat in hospitals. If cases keep growing at this rate, we’ll hit that limit around April 18th, about the time experts predict the number of cases in the U.S. will hit their peak. That is, of course, a worst-case scenario. There is ample evidence to suggest that coronavirus isn’t growing at a steady exponential rate, but at a slowly decaying exponential rate, meaning that in a week or so, instead of cases doubling every 4 days, they might only be doubling every 5 or 6 days.
THE GOOD NEWS: Here’s a more optimistic outlook, which predicts we won’t hit the peak number of hospitalizations in Florida until May 14th, and at that, worst-case, it’ll only be around 5,600 beds, or about 30 percent of our total capacity (click the image to enlarge it- if you’re viewing on mobile, sorry…):
MORE GOOD NEWS: We have yet to see the full impact of social distancing measures put into place, which will almost certainly be visible very soon in the number of daily cases, and in particular, the number of hospitalizations.
We also have a top-notch state emergency management team, with skills honed annually by Florida’s hurricane season. As any of those state experts will tell you, emergency management is not about the crisis itself, but managing the logistics of recovery after the storm has passed. Apply that same expertise to the coronavirus outbreak, and we can be confident that our state leaders will be able to identify critical supply shortages and surpluses, and rapidly shift essential medicine, equipment and personnel to where they are needed most.
CONCLUSION
The number of COVID-19 tests in the United States has grown significantly over the past week, and with it, the number of COVID-19 cases we have identified. Our nation now leads the world in total number of cases identified – with more than 101,000 so far. Of those, a shocking 44% are located in New York State, and half of those cases are in New York City. Without a doubt, COVID-19 is a highly contagious virus with serious consequences for about 20% of the population.
In New York, this is an extremely serious crisis without parallel in modern life. Here in Florida, the situation is still fluid, but currently under control, albeit with severe restrictions on everyday life.
As other media outlets continue to report on the sheer number of cases, keep in mind that number is largely irrelevant, as the only statistics that truly matter are the number of hospitalizations and deaths. Those figures are NOT going up due to a sudden surge in testing, but because they are real people requiring real medical care. And those are the numbers that will also matter politically when this terrible outbreak is finally behind us.
The best thing we can do right now is to hunker down, heed the advice of our elected leaders, and help reduce the impact of this nasty virus.
More analysis soon when more data becomes available. Stay tuned…