Corona Virus Pandemic update by Dr. Seheult

While discussion with Dr. Sehuelt regarding current update for corona virus pandemic he narrated that it’s different everywhere depending on which state you’re living in and if you’re living outside of the United States it can also be tricky or interesting to find out whether or not there’s a surge occurring in your region and for that I wanted to point out the testing tab here at the johns hopkins corona virus resource center so if you go here to testing at the top you’ll see here this is the johns hopkins Covid 19 testing incites initiative and there’s a number of tools here what I wanted to draw your attention to is the testing insights tracking and analysis and here you can go to individual states States comparison testing positivity or international comparisons here we’re going to go first to individual States and what this show is on a state-by-state basis is how many total daily virus tests are being conducted in each state and how many of those tests are positive so I’ll give you a positive index or positive percentage and there is a running seven-day total so for instance let’s go down here and you’ll see for the entire United States how many tests were being done before March 29th and how many have been done on a daily basis since that time and I’ll also show you here in the dark yellow at the bottom how many were actually positive of those tests so you can see here that we have done a lot of testing here in the United States and we’re testing more people than ever before and as a result of that we’re catching more and more people but the number of people that we’re catching on a daily basis has really not changed as a total in the United States and as a result of that you can see this line is a percentage of the daily tests that were positive and you can see here that where we are currently as at a positive rate overall in the United States of 4.6% and that’s the 7 day moving average there is some guidance that from the w-h-o they say here that the w-h-o has said that in countries that have conducted extensive testing for Covid 19 they should remain at 5% or lower for at least 14 days and that’s the positive percentage rate they say here that if a community’s positivity

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is high it suggests that the community may largely be testing the sickest patients and possibly missing milder or asymptomatic cases importantly it also says here that this initiative relies upon publicly available data from multiple sources and that states are not consistent in how and when they release and update their data and some may even retro actively changed the numbers that they report this can affect the percentages that you see presented in the data visualizations and they’re taking steps to account for these irregularities in how they present the information so in light of that it’d be interesting to see particularly those states in the news that are the subject of increase surge and that would be particularly in Florida Texas and Arizona so let’s take a look here’s Arizona we can see here that testing has ramped up but in addition to that we’re also seeing here in dark yellow that the number of positive cases has also gone up and you can see clearly that the percent is around 17.7% far above 5% and this would go along with what they’re experiencing Arizona right now which is they are near or overcapacity in terms of their ICU beds if we take a look here at Texas we see a similar situation we see here that they’re doing a lot more testing which is good but they’re also picking up a lot of Covid positive cases and so our positive index is above five percent at seven point nine percent okay let’s take a look at Florida you can see here that the number percentage had gone down and reached a nadir around late May but since that time it’s been going up and that since Memorial Day we can see here that positives are about 5% at 7.0 percent and testing seems to have come down slightly from its peak around the middle of May so let’s go to the epicenter at the beginning of the pandemic in the United States New York you can see here clearly that New York has ramped up its testing to very high levels getting good data and the number of positives is around 1.1 percent so we’re not seeing a new surge here in New York let’s also take a look at California again we’re seeing a lot more testing being done however it looks as though in California that the positive rate is staying south of that 5% cutoff let’s hope that stays is reality Hawaii is another area that is being looked at you can see here almost not reportable positives are at 0.9% and they’ve done some work here in terms of testing for those living outside the United States we can go to international comparison and we can see here on a line that measures exactly where different countries are on this scatter gram that looks at daily percentage of positive tests versus daily number of tests per hundred thousand population all-time average now interestingly it says here that the United States has conducted more Cova 19 tests than any other country however there is no expert consensus on a recommended target for the raw number of tests or even the rate of tests per capita and the graph above demonstrates why using these statistics alone can be misleading and the key message here is that testing program should be scaled to the size of their epidemic not the size of the population you can see here that the size of the circle is proportional to the Daly confirmed new cases on average here’s that red line that we talked about the 5% so I think this part of the website that we’ve linked to is going to be a helpful tool for individuals throughout the world in terms of what’s going on in their country and in their part of the country and speaking of global if we look at the daily new cases on roll domitor will see that the daily new cases as at an all-time high overall but yet when we look at daily deaths they seem to be decreasing and what is it that can explain the fact that while more and more people all over the world are testing positive the number of daily deaths are continuing to sort of decline of course the answer to that is only speculative but may include the fact that we’re testing more people it could also be that we’ve got better treatments in the hospitals [Music] of course all of these explanations are merely speculative but we can only hope that the daily death trend continues to decrease and of course one of those new drugs is dexamethasone this is the steroid that was touted in the recently released trial out of Oxford that showed that dexamethasone reduced mortality by thirty five percent in those patients on ventilators now we have to be careful because this data has not been peer-reviewed and has not been published and while we wait for that data to be published there are signs of encouragement in the treatment trial they only use this steroid for ten days either intravenously or orally now when you use dexamethasone for ten days generally speaking you’re not going to have the side effects such as osteoporosis cataracts diabetes and things of that nature what you do have to worry about is whether or not your patient has a secondary infection obviously the patient already has a primary infection that of a virus but there could also be secondary infections such as bacterial or fungal infections that are ongoing in the patient that’s ill in those patients that were not on oxygen but very very early in the course when they were given dexamethasone there was no statistically significant increase or decrease in mortality indicating that this medication dexamethasone a cortical steroid is best used in patients who are further on down the timeline of Cova 19 where there is cytokine storm as manifested by hypoxemia or a lack of oxygen so this led the w-h-o director-general to say that this is the first treatment to be shown to reduce mortality in patients with Cova 19 requiring oxygen or ventilator support this is great news and I congratulate the government of the UK the University of Oxford and the many hospitals and patients in the UK who have contributed to this life-saving scientific breakthrough so I believe the good news here is that this is a very inexpensive medication as its off patent and unfortunately though it’s not gonna be a medication that you’re gonna want to stockpile at home and try to take if you come down with coronavirus because it doesn’t seem to help unless you need to be on oxygen and if you need to be on oxygen you probably should be in the hospital and not at home and with that I just wanted to remind you that each country has its own story and you can follow that here at the johns hopkins coronavirus resource center

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