20200426

Sun Apr 26 06:00:01 EDT 2020 ======================================== Slept from one to eight. Woke briefly around five. A little tired; might nap later. Mostly cloudy with a 20 percent chance of rain in the morning, then mostly sunny in the afternoon. Highs in the upper 50s. Northeast winds 15 to 20 mph. To Do ---------------------------------------- - Laundry Done. - Census Done. - Possible Instacart delivery sometime today Yes! Confirmation #: 2edc2ccc-8e10-4499-bbd5-dad1c9c41e16 Forty-minute walk in the morning. Hazy sky, not cold. Saw lots of robins, a seagull, a pair of morning doves, a small woodpecker, and a blue jay. More buds bursting on trees, but no real leaves yet. Passed a few people walking; most wore masks. Vacuumed, watered plants, washed dishes. A very productive day, as far as getting chores done. Got everything done early, leaving me free to relax in the afternoon and evening. https://www.theatlantic.com/technology/archive/2020/04/us-coronavirus-outbreak-out-control-test-positivity-rate/610132/ > According to the Tracking Project’s figures, nearly one in five people who get tested for the coronavirus in the United States is found to have it. In other words, the country has what is called a “test-positivity rate” of nearly 20 percent. > That is “very high,” Jason Andrews, an infectious-disease professor at Stanford, told us. Such a high test-positivity rate almost certainly means that the U.S. is not testing everyone who has been infected with the pathogen, because it implies that doctors are testing only people with a very high probability of having the infection. People with milder symptoms, to say nothing of those with none at all, are going undercounted. Countries that test broadly should encounter far more people who are not infected than people who are, so their test-positivity rate should be lower. > Because the number of Americans tested for COVID-19 has changed over time, the U.S. test-positivity rate can’t yet provide much detailed information about the contagiousness or fatality rate of the disease. But the statistic can still give a rough sense of how bad a particular outbreak is by distinguishing between places undergoing very different sizes of epidemics, Andrews said. A country with a 25 percent positivity rate and one with a 2 percent positivity rate are facing “vastly different epidemics,” he said, and the 2 percent country is better off. > In that light, America’s 20 percent positivity rate is disquieting. The U.S. did almost 25 times as many tests on April 15 as on March 15, yet both the daily positive rate and the overall positive rate went up in that month. If the U.S. were a jar of 330 million jelly beans, then over the course of the outbreak, the health-care system has reached in with a bigger and bigger scoop. But every day, 20 percent of the beans it pulls out are positive for COVID-19. If the outbreak were indeed under control, then we would expect more testing—that is, a larger scoop—to yield a smaller and smaller proportion of positives. So far, that hasn’t happened. > So while the U.S. has a 20 percent positivity rate, South Korea’s is only about 2 percent—a full order of magnitude smaller. > South Korea is not alone in bringing its positivity rate down: America’s figure dwarfs that of almost every other developed country. Canada, Germany and Denmark have positivity rates from 6 to 8 percent. Australia and New Zealand have 2 percent positivity rates. Even Italy—which faced one of the world’s most ravaging outbreaks—has a 15 percent rate. It has found nearly 160,000 cases and conducted more than a million tests. Virtually the only wealthy country with a larger positivity rate than the U.S. is the United Kingdom, where more than 30 percent of people tested for the virus have been positive. > But New York, so far the hardest hit state in the U.S., has an even higher rate of 41 percent. And in New Jersey, an astounding one in two people tested for the virus are found to have it. > The prevalence of COVID-19 might be higher in the New York area than anywhere else in the country, but high test-positivity rates are not confined to the mid-Atlantic. Five other states have a positive rate above 20 percent: Michigan, Georgia, Massachusetts, Illinois, and Colorado. They are spread across the country, and they all have obviously serious outbreaks. Each of the eight states with positive rates over 20 percent has, individually, reported more COVID-19 deaths than South Korea. > At the beginning of a pandemic, both the actual number of infections and the number of tests per day shoot up, and the positivity rate is controlled by whichever happens to grow faster, he said. In this case, the faster-growing number appears to have been infections. “As things stabilize, if the testing rate declines and the positivity rate declines, you have some good signal that the epidemic is declining,” he said. As MI does more tests, the positive rate drops. That may be very good news. https://www.npr.org/sections/coronavirus-live-updates/2020/03/30/824127807/if-most-of-your-coronavirus-tests-come-back-positive-youre-not-testing-enough > "If 80-90% of the people test positive, you are probably missing a lot of cases," says Michael Ryan, executive director of the WHO Health Emergencies Program. > In places where every close contact and suspected case has been tested, the percent of negative cases is high. Ryan says in countries that have extensive testing, fewer than 12% of their tests are positive. > "We would certainly like to see countries testing at the level of ten negative tests to one positive, as a general benchmark of a system that's doing enough testing to pick up all cases," Ryan says. https://www.npr.org/sections/health-shots/2020/04/22/840526338/is-the-u-s-testing-enough-for-covid-19-as-debate-rages-on-heres-how-to-know > There's no exact number to aim for, but here's a guiding principle: You want a low percentage of your tests to come back positive, around 10% or even lower, says William Hanage, an epidemiologist at Harvard. > That 10% benchmark is based on recommendations from the World Health Organization. Why should positives be low? If a high percentage of tests come back positive, it's clear there's not enough testing to capture all of the infected people in the community. "The lower the percentage of tests you're doing that come back positive, the better," Hanage says. US new tests: 158,462 → 156,388 → 140,959 → 167,229 → 137,900 → 151,540 → 313,608 → 193,479 → 223,552 → 300,833 → 256,444 (today) (three-day averages: 151936 152223 243546 278639) US new deaths: 1496 → 1450 → 2299 → 2492 → 2136 → 2069 → 1774 → 1654 → 1528 → 2674 → 2133 → 1886 → 1772 → 2194 → 1184 (today) (three-day averages: 1748 2232 1652 2231 1717) MI new tests today: 3423 → 3207 → 3582 → 3471 → 4589 → 4673 → 768 → 9934 → 4137 → 3428 → 999 → 10096 → 7975 → 7748 → 49835 (??!!) (today) (three-day averages: 3404 4244 4946 4841 21853) MI new tests positive percentage (we want 10% or less): 19% → 31% → 38% → 30% → 26% → 16% → 100% → 6% → 14% → 28% → 100% → 13% → 17% → 7% → 1% (today) (three-day averages: 29 24 40 47 8) MI new deaths: 95 → 115 → 166 → 153 → 172 → 134 → 81 → 83 → 77 → 232 → 113 → 164 → 108 → 189 → 41 (today) (three-day averages: 125 153 80 170 113) Oakland county new deaths: 28 → 18 → 16 → 17 → 18 → 16 → 8 → 21 → 9 → 16 → 14 → 6 → 4 → 1 → 0 (today) (three-day averages: 21 17 13 12 2) Beaumont 4/23: COVID-19 patients: 701; COVID-19 ICU patients: 174; all patients bed occupancy: 57% Can the number of MI tests possibly be right? Great, if true and sustainable. Servings: grains 5/6, fruit 1/4, vegetables 2/4, dairy 3/2, meat 2/3, nuts 0/0.5 Lunch: bagel, egg, cucumber, coffee Afternoon snack: orange, Cheetos Dinner: salami, cheese -31 110/67

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