Covid-19: A Santa Barbara, California, Clinic's Experience -- September 23, 2020

Disclaimer: in a long note like this there will be typographical and content errors. I often misread data from original sources. There's probably a bunch of other stuff that I could say, but that will suffice for now. This was done for my benefit. If this is important to you go to the original sources. Again, I often make simple arithmetic errors, and I often make typographical and content errors in long notes like this. 

Link here.

This is an incredible note from a clinic to its patients. I am more than impressed.

I scanned through it fairly quickly. As I said I am quite impressed. Impressed that a clinic would send out such a long note to its patients. Obviously, they have a very, very well-educated population.

But for such a long epistle I'm more surprised at what is not mentioned (again, these may have been mentioned and I simply missed them):

• demographics (such as age, pre-existing medical conditions, living arrangements) for those that have died of Covid-19 verified by at least two positive tests; three would be better, based on number of false positives being reported
  
• hospitalizations due to Covid-19 as the primary diagnosis
• average length of stay in hospital with Covid-19 as primary diagnosis
  
• percentage of all hospitalizations 
• compared with seasonal flu
  
• ICU admissions due to Covid-19 as the primary diagnosis
• percentage of all ICU admissions
• percent survival if admitted to ICU; average length of stay in ICU 
• compared with seasonal flu
  
• percent bed occupancy throughout calendar year, 2020
• compared with seasonal flu
  
• medical intervention strategies being used (hydroxychloroquine; steroids; anti-virals)
• success rate of medical intervention
• what's working; what's not
  
• pet peeve: focus on number of cases -- irrelevant, inaccurate, and in-covfefe
• pet peeve: no comparison of Covid-19 death rates with those of seasonal flu
• pet peeve: no disclaimer that seasonal flu numbers are for a single season (i.e., about six months); whereas Covid-19 has now been going on perhaps as long as nine months and no end in sight;
  
• reimbursement (dollar amount) from Medicare for Covid-19 diagnosis and whether that requires a confirmatory diagnostic test or simply based on a physician's impression/diagnosis
• compared with seasonal flu
  

From the article, Covid-19 statistics:

• death rate for seasonal flu, according to the CDC
• 50,000 deaths / 50 million cases in the US = 0.001 or 0.1%
• 50,000 deaths / 350 million US population = 0.000143 or 0.00143%
• death rate for Covid-19 in the US according to Johns Hopkins:
• 60 deaths / 100,000 cases = 0.0006 or 0.06%

Again, according to the CDC, regarding seasonal flu:

• 50,000 deaths annually in a US population of 350 million = 0.000143 = 0.001%

From Johns Hopkins, regarding Covid-19:

• 60 deaths so far for every 100,000 population = 600 deaths per million or 210,000

The time frames being used are different for Covid-19 and seasonal flu:

• seasonal flu numbers are based on one season: six months
• the US attempted to flatten the curve, and deaths will be spread out over a much longer time frame which makes it hard to compare seasonal flu with Covid-19
  

Having said that, Covid-19:

• 210,000 deaths / 350 million = 0.0006 = 0.06%
• using these numbers, Covid-19 has a death rate / 1 million population that is 60x that of seasonal flu

By the way, that "210,000" is uncannily close to actual number of deaths in the US reported as of yesterday, which was 205,471. Link here.

By the way, if these numbers are even remotely close, there was no question that the right strategy was to "flatten the curve." Seasonal flu with 50,000 deaths / 50 million cases despite a vaccine puts a huge stress on the US every year, and on the healthcare system specifically. Compressing the current 200,000 deaths  over nine months into three months which might have happened without attempts to "flatten the curve" would have been quite a challenge for the health care industry and the US population in general. 

One can argue, President Trump and the governors did not go far enough, but one can also argue that overall, "we've" done pretty well given all the conditions, least of which political in an election year.

Disclaimer: I often make simple arithmetic errors.