9 June 2020 Blog Post: Coronvirus in Los Angeles County

When my kids were little, little we would watch Sesame Street before they went to school. Each show had a “Word of the Day.” Today’s word is worrisome.

You may have seen press reports stating that COVID-19 rates are starting to climb in Los Angeles County. Emergency Department doctors have stated that they are beginning to see an uptick in cases as well.. Worrisome. (Β https://www.latimes.com/california/story/2020-06-08/los-angeles-reopens-coronavirus-transmission-rate-climbing?fbclid=IwAR35ZoEXIM0Bc0hHzE5hCAIWoCDbAzivDAL05wg289nnFeM9Vl589_SJsLo)

Unfortunately, these anecdotal reports are correct..
Β 
Those who have followed my previous posts may remember that Los Angeles County had posted several weeks in a row of consistent decreases in cases. Now analyzing their updated numbers from this morning, only a visible drop is noted between the weeks of 5/1/2020 and 5/8/2020 (Figure 1). Daily rates have increased in each of the 4 subsequent weeks beginning 5/15/2020 (although are somewhat flat). But this indicates significant delays in case reporting from the County – somewhat unsurprising since I report cases by FAX rather than a direct data upload. Reporting delays at the County level are also – well – worrisome.
Most worrisome, is that testing rates in Los Angeles have plummeted (Figure 2). So we are seeing more cases with less testing. Worrisome indeed.

The only good news is that mortality rates are in steep decline (Figure 3). A number of factors could explain such. For instance, we may be testing more younger individuals who tend to have disease that is less often fatal (certainly possible given #SaferAtHome mandates directed at seniors). Alternatively, there is an even longer lag time before mortality rates tick higher and we may graphically be seeing a calm before the (second) storm.

There is room for vigorous debate about the effects of protest marches, accelerating opening of businesses and relaxing public health mandates on face covering. However, I think that in all of this there is one inexcusable (and fixable) phenomenon – reporting delays at the County level. With all of the effort that has been put into Electronic Medical Records and claims of interoperability, data are either not getting to or being processed by the County fast enough. So we are always going to be 2-3 weeks late in our decision making, simply as a result of fixable actuarial delays. Its like watching the Oscars but waiting for Price-Waterhouse-Cooper to tell you the winners 3 weeks after the show ends.

Worrisome.

𝗦𝗢𝗴𝗻 𝗨𝗽 𝗳𝗼𝗿 π—’π˜‚π—Ώ π—‘π—²π˜„π˜€π—Ήπ—²π˜π˜π—²π—Ώ

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