Of Numbers and Pandemics...

 

    There is too much data and not enough COVID-19 information in the year 2020.  What is the difference?  Data tells you numbers, information tells you numbers in a way that is useful. How many of us sit around hearing number after number on the internet, social media, and television and wonder just what those numbers really mean. So, today I want to provide a little primer on three things you have to know to understand what those numbers really mean: Rt Number, Total Infected, and the Ohio Public Health Advisory Indicators.  Don't panic...it all makes sense. 

    First of all I want to introduce you to my little friend: Rt Number.  What is Rt?  Rt, or reproduction rate, is a ratio that tells you how many new people are being infected versus how many people are already infected.  Imagine 100 people have COVID-19 and they infect 100 people.  That is a 1 to 1 ratio, or an Rt of 1.0 (in other words 100%).  If 100 people infect 75 people then that is a .75 and it indicates that the disease is declining.  If 100 people infect 125 people, then the number is 1.25 (as it is at the moment in Ohio) which indicates that it is increasing (125%).  

    Time for some math.  If the number stays 1.25 and does not increase, that is actually a bad thing.  Why?  Math.  An Rt of 1.25 would mean that on a daily basis cases go up 125%.  So if we have 10,000 cases this week, we will have 12, 500 next week.  Next week the number goes to 15,626 because the total is compounding exponentially.  Even if the Rt Number does not go up (because a 125% increase on 12, 500 is 15, 626) the total number of cases will.  In the same way a number under 1.00 will also cause the cases to decrease faster each week exponentially.  So an Rt of .85 is is more and more effective in reducing the curve each week it is around.  So...if you know your state's Rt Number you can predict how many new cases there will be each week...If you know the total number of infected individuals. 

    Right now there are lots of ways of determining how many folks have COVID-19, and lots of controversy as to how those numbers are calculated.  The state of Ohio has kept track of how many confirmed cases there are on a day by day basis.  How accurate is this number?  Very.  Does this tell the whole story?  Hardly.  Of course the total number of cases has continued to rise dramatically.  However, so has the the amount of testing to determine if someone has COVID-19.  How do we know that the spike in cases (which has eclipsed the number of cases we had April of last year by over a factor of 10:  April 13, 2020 - 475 cases, November 19, 2020 - 7,729 cases) is not due to increased testing?  Some is.  So we have to look at other factors, which is why our state has Public Health Advisory Indicators. 

    The state of Ohio looks at Seven Indicators: New Cases Per Capita, Sustained Increase in Cases, Proportionate Cases in Non-Congregate locations, ER visits, New COVID Hospitalizations, Doctors Outpatient Visits, and Total number of ICU beds available.  All of this is done on a county by county basis.  Each of the seven indicators are given a baseline that determines if this indicator should be considered "at risk".  For example if our county has 50 or more new cases per 100,000 residents it is check marked as "at risk".  If the total number of ER visits or Hospitalizations increase every day for five days in any week each of those would be checked as "at-risk".   If 0-1 of those indicators are check marked as "at risk" your county will be marked yellow, 2-3 orange, 4-5 red, and 6+ purple.  

    So it is more than just the total number of confirmed cases.  Sadly, most counties are now red.  To get out of red you have to fall below 4 indicators AND have less than 100 cases per 100,000 people for two weeks straight.  Which, so far, is hard to do.  As you can see by our map, we are almost all red.  Each week on Thursday at 2:00PM a new map is published. 

    What do we do with this?  We understand our roles.  Lets address the tough ones: masks, closures, and health codes.  

    I know that the governor has mandated masks and this has led some folks to say, "he can't do that!" ...and actually he can.  Under the guidance of the Ohio Department of Health they can declare any business closed when in violation of health codes...just like closing a restaurant full of cockroaches.  Are masks effective?  According to the CDC, cloth masks are 50-70% effective.  So why wear them if they are not 100% effective?  Simple.  We are not trying to get the Rt Number down to 0.00 (as nice as that would be)...we just need it under 1.00 to set us in the right direction.  If the estimated 30% of the population not wearing masks wear them...poorly...only getting them 50% effective...then that would be a 15% drop in the Rt Number.  Well, we would still be at 1.10, then what?  Further measures from the government targeted at primary locations of contagion.  Bars, restaurants, and gyms may be next.  Would that be 100% effective?  No.  But even if it only limits the spread by 10% we are down to an Rt of 1.0.  Then what?  It is hard to say. But we will also have to sacrifice something for the greater good in all likelihood.   

    I have no interest in determining if the disease is a massive health risk or a tempest in a teapot.  I am not endorsing or disputing any particular evaluation of the health risks we face.  I simply want folks to understand the slew of numbers that media spits at us on any given day.  I hope this helps you sort all the various, often contradictory sounding, and confusing data.  God bless, and have a great day. 

For further thought:  Some websites to keep you updated.

https://rt.live/

https://coronavirus.ohio.gov/wps/portal/gov/covid-19/public-health-advisory-system

https://coronavirus.ohio.gov/wps/portal/gov/covid-19/dashboards/overview/

https://www.cdc.gov/coronavirus/2019-ncov/more/masking-science-sars-cov2.html

https://coronavirus.ohio.gov/static/publicorders/retail-and-business-compliance-facial-coverings-all-ohio.pdf