re: Daily COVID Updated as of 11/2/20 8:00 PM

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I'm incredibly curious as to the huge difference in the NYC numbers versus other large cities. Whether it is a case of prior herd immunity in Ca or different strains or just happenstance it is really unusual

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I actually just came across this thread from a biostatistician at University of Florida regarding both IMHE model and the paradoxical phenomenon that are occurring.

1. Basically, the model is fitted around deaths since it’s probably the most well-measured, objective, and consistent variable even though it’s a lagging indicator. Then it back fits the other data based on assumptions of their relationships with deaths.

2. In the most recent adjustment, the ratio of hospitalizations to deaths decreased from 11.1 to 7.1. So the model then assumes fewer resources are needed and this the peaks for those resources will be sooner and lower.

3. And as a result, deaths follow a similar trend.

4. However, what she found are the states hit the hardest (e.g., New York, 4.22) have a far lower hospitalization to death ratio than stated doing much better (California, 10.61).

5. This is paradoxical because fewer hospitalizations reviews less demand on the hospitals, resulting in poorer care, and increases the rate of deaths as well on top of being an indicator of deaths itself.

6. Her hypothesis is that in New York, people are being hospitalized (for whatever reason) too late, and die more quickly and frequently. So the hospitals have less demand, but aren’t able to provide the services to better save them.

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