re: Dallas County Covid-19 cases exceed 700 yesterday

It's definitely a bit misleading and focusing on cases is the wrong way to do it in terms of the restrictions, though there is legitimacy to the concern that this wave started with young people who aren't as likely to be affected and if left unchecked will spread to the older, more vulnerable population which could stress the hospital system.

That said I don't know what the exact stats are on that at this point, just that it shouldn't be an all or nothing thing with the level of concern.

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Is that bad? People are going to get it. I thought the issue was hospitals being overrun. Are they being overrun?

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From what I understand Parkland is pretty full. A doctor friend was there yesterday and they have a lot of cases. The thing about Parkland is it is the public hospital - meaning low income, meaning the folks who were protesting, meaning it isn't opening up or masks, it is the freaking protests.

I have another doctor buddy who is on the board of a large radiology group and they look at images from across the metro. He has emails multiple times a day on hospital capacities from around DFW he actually reviews the lung scans and says none of the hospitals they cover are stressed and with improved treatments there is less likelihood of ICU visits for those infected. He thinks strongly we are on the downward side of this thing even as more cases pop off.

General Counsel for ER Clinics in Texas

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Good morning,

I am the Managing Partner and General Counsel of a Texas based company that owns and operates 13 free-standing emergency clinics in the State of Texas. I follow your reporting and wanted to share with you some information on Texas. I want people to hear this story as opposed to the mainstream reporting. However, I am sensitive about putting a target on myself or my company for conveying this information. I am not sure how you’ve handled this type of situation but I suspect you’ve had other people send you information who are concerned about becoming a target.

In June, we tested over 2,231 patients (data through last Thursday). Positive rate is now close to 20% (was 4-6% in May). Vast majority of the cases are mild to very mild symptoms. Average age of the people getting tested in mid-30s.

Very different patient (in terms of age) than we’ve seen before June. Most of these patients would not have met criteria that we previously had (and all the health facilities had) for Covid testing. Now with more testing kits we are able to test a broader group of patients.

Clinically, we’ve had very few hospital transfers because of Covid. Vast majority of the patients are better within 2-3 days of the visit and most would be described as having a cold (a mild one at that) or the symptoms related to allergies. We’ve often provided a steroid shot and some antibiotics. By the time we have follow-up calls, most of the patients are no longer experiencing any symptoms. They often say the shot really made a difference.

In terms of what is driving them to the ER — Roughly 1/2 have been told by their employers to get a test. They have a sneeze or a cough and their employer tells them to go get tested. The other 1/2 just want to know. They have mild symptoms (and some don’t have any symptoms but game the system and check a box that they have a symptom so they can get a test — they cannot get a test unless they present with symptoms. If they have no symptoms we send them away — which does happen.)

The average length of stay of Covid patients is 3-5 days. Much lower than the patients being seen in April and early May. Their symptoms are also milder. Most of the patients are not ending up in the ICU. The hospital ICUs are filled with really sick people with non-Covid issues. They [didn’t] come in earlier because they were scared and now they are super sick. From multiple sources at different hospitals — they have plenty of capacity and no shortage of acute care beds.

No real data on breakdown of patients who have Covid but are not in the hospital because of Covid. Recognition that because all patients are tested for Covid you have some percentage of patients listed as Covid patients who are non Covid symptomatic and that the hospitalization rate is somewhat driven by hospitals taking their normal patients with other medical issues.

Finally, heard several stories of how discharge planners are being pressured to put Covid as primary diagnosis — as that pays significantly better. Hospitals want to avoid the discussion but if they don’t they risk another shutdown. This may be an explanation for why there is a gap in hospital executives saying they have plenty of capacity and the increasing number of Covid hospitalizations. You open up your hospitals for normal medical care and you test everyone (sic) of those patients — the result is higher percentage of patients who have Covid — now.

Overall, based on what we are seeing at our facilities, the above information is really a positive story. You have more people testing positive with really minimal symptoms. This means that the fatality rate is less than commonly reported.

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"Show me the incentive and I will show you the outcome"

-Charlie Munger

The people understand. The local governments also have an incentive to stay shutdown for longer. They have elections to win and careers to make finger pointing at how all of their actions cured the virus lol Clay Jenkins is in for a rough decade in Dallas if this is the road they want to go down.

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wutangfinancial

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I think it's worth posting the chart in that link:

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why do more ppl have to die

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Because it's a non seasonal respiratory virus.

Everyone will be exposed/infected.

We can mitigate by isolating the frail.

It's sad. People will die. But, that's simply reality.

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If someone has an antibody test and it comes back positive they’re listed as a new case

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Do we know if the positives are unique to individuals.

In other words, if someone is positive and needs a 2nd test before returning to work, does a 2nd positive count too?

The problem is the Dallas county government is being too vague, and they are doing this tweener strategy that doesn't make sense. Enforce masks and open everything up or shut everything down and wait for a vaccine (lol). Why are we splitting the difference? It's absolutely destructive to the county from a financial perspective. Who's going to pay for the shortfalls in revenue?

That link doesn’t say that, but does highlight another issue with the data. Combining viral and antibody tests into one “testing” number is misleading.

I guess this is what you’re using to say the 10 tests extreme though. It’s absurd that we can’t track these by case and not just by test. One person should be counted once. It’s nonsense.

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CDC spokesperson Kristen Nordlund said another thing that makes federal numbers higher than state numbers is that the CDC tracks the total amount of tests conducted, rather than the number of people tested, as Florida currently does.

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No, most facilities in the metroplex have doubled Covid admits.

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I was reading that UTSW spiked up since Memorial Day, but has seen a decline this past week.