Dr. Matyas responds to my request for daily updates on TOTAL hospitalizations since the pandemic began
By Roger Straw, September 28, 2020
Background
Roger Straw, The Benicia Independent
On September 24, I wrote to Dr. Bela Matyas, asking him to restore a TOTAL count of COVID hospitalizations since the pandemic began:
Please consider this request: From the earliest days of the pandemic and through July 10, the County’s COVID dashboard showed Total Hospitalizations.
Beginning on July 13, the dashboard only shows Current Hospitalizations. The daily change in Current Hospitalizations must be the difference between admissions and discharges, plus or minus, which is important to know.
However, the public needs to also know how many NEW admissions on a daily basis in order to accurately understand spread. This can easily be seen in the daily update of Total Hospitalizations.
Please consider restoring Total Hospitalizations to the COVID dashboard.
Dr. Matyas sent the following reply on September 27:
Dr. Bela Matyas, Solano County Public Health Officer
“The daily change in total hospitalizations does not faithfully represent new hospitalizations; the majority of added hospitalizations day over day is from reconciliation of previously hospitalized cases that we learn about in arrears. It is likely to be a substantially under-reported number.
Hospitalization is not a reportable condition on an individual level; hospital capacity is the condition that we are monitoring, and total hospitalizations per day is the relevant metric. Reporting total hospitalizations to date on a daily basis would be a misleading indicator for tracking new hospitalizations both because of the timing of reports and the under-reporting of hospitalizations.”
My response today:
Dr. Matyas – Thank you for your response to my email. With respect, I think I disagree. Regardless whether a daily update of TOTAL hospitalizations since the outbreak began includes ONLY new hospitalizations TODAY or both new TODAY and “newly learned in arrears” hospitalizations, the metric of total hospitalizations (and a 7 or 14 day average graph showing the curve of that metric) would be of great significance in understanding the overall spread of the most serious cases.
This daily increase, whether learned in arrears or not, is important for the public’s awareness. MOST IMPORTANTLY, reporting on hospitalizations in this way might help in cautioning the public to take seriously the continuing need for masks, social distancing, hand washing, etc. As our public health officer, I’d hope you might stop and think about this again. Seems it wouldn’t hurt the cause at all to add this metric to the County’s COVID dashboard, and shouldn’t be too hard to calculate the data as I have been doing, working from the AGE GROUP data.
I will continue to add together the newly reported daily reported increase of hospitalizations in the AGE GROUP data in order to determine the daily increase in TOTAL hospitalizations. And I will continue to let the public know.
Roger Straw
Benicia
Click the image for Solano County COVID-19 Updates and Resources
State will assemble a “review board” of leading scientists
FILE – In this July 27, 2020, file photo, Nurse Kathe Olmstead, right, gives volunteer Melissa Harting, of Harpersville, N.Y., an injection as a study of a possible COVID-19 vaccine, developed by the National Institutes of Health and Moderna Inc., gets underway in Binghamton, N.Y. A letter from federal health officials instructing states to be ready to begin distributing a vaccine by Nov. 1 — two days before the election — has met, not with exhilaration, but with suspicion among public health experts and others. (AP Photo/Hans Pennink, File)Vallejo Times-Herald, By Lisa Krieger, September 26, 2020
California will conduct its own independent review of potential COVID-19 vaccines, signaling its distrust of the Trump administration’s accelerated “Operation Warp Speed” initiative.
To vet a vaccine before distribution to state residents, California Health and Human Services Secretary Dr. Mark Ghaly said Friday that the state will assemble a “review board” of leading scientists at academic institutions to assess the safety and effectiveness of any vaccine candidate.
“We think it is an appropriate approach to take, especially because things are moving so quickly,” Ghaly said. “We want to make sure — despite the urge and interest in having a useful vaccine — that we do it with the utmost safety of Californians in mind.”
The announcement came at a press conference in which Ghaly also expressed concern that California’s coronavirus numbers are beginning to move in the wrong direction after weeks of declines. Based on current trends, he projected an 89% increase in COVID-19 hospitalizations over the next month. That would still be far below hospital capacity and the worst rates in other states.
On the vaccine testing issue, several other states, including New York, have signaled that they’ll also take the unusual step that Ghaly outlined.
“Frankly, I’m not going to trust the federal government’s opinion, and I wouldn’t recommend to New Yorkers, based on the federal government’s opinion,” New York Gov. Andrew M. Cuomo announced at a Thursday news briefing, according to the New York Times.
President Trump has insisted a vaccine will be ready as early as next month, an assertion that other federal authorities say is unlikely.
California is already building a rollout plan for distribution of the vaccine, including whom to prioritize in the process, said Ghaly.
Led by the state’s Department of Public Health, members of a new Vaccine Task Force include other state agencies, as well as academic experts, community groups and individuals.
Once the state confirms the safety of the vaccine, this task force will advise distribution “in an equitable and smart way, to serve all the needs of Californians,” said Ghaly. “That absolutely is our plan.”
Conflicting information about the timing of the vaccine and whether it will be safe and adequately tested has created growing concern that people are hesitant to take it, despite its importance in stopping the pandemic.
The share of Americans who say they would get vaccinated for the coronavirus has declined sharply since earlier this year, according to a survey conducted this month by the Pew Research Center. About half of U.S. adults (51%) now say they would definitely or probably get a vaccine to prevent COVID-19 if it were available today, down from 72% in May.
Only about 21% said they would definitely get a coronavirus vaccine, half as many as in May.
While it is the federal government’s role to approve a vaccine, states have authority for actual distribution — and could, in theory, reject a vaccine they think is unsafe.
“Each state, indeed, has that sort of responsibility,” said Vanderbilt University’s Dr. William Schaffner, an internist and infectious disease specialist who formerly worked for the U.S. Public Health Service and the Centers for Disease Control and Prevention, at a Sept. 24 National Press Foundation program. “Some may be more ready to independently evaluate the data than others.”
An FDA committee — called the Vaccines and Related Biological Products Advisory Committee comprising 15 authorities selected by the FDA commissioner — reviews the safety and effectiveness data at a public meeting. The FDA commissioner usually follows the committee’s recommendation, but not always.
Typically, states follow the decision of the Advisory Committee on Immunization Practices, or ACIP, an independent committee that assesses data on FDA-approved vaccines and makes recommendations to the CDC.
But there is growing worry that the federal regulators may feel pressure from the White House to activate “Emergency Use Authorization” of an unlicensed vaccine, which would not require completion of a full “Phase 3” trial, during which efficacy is tested in thousands of people.
Two other COVID-19 products — hydroxychloroquine and convalescent plasma — received emergency use authorization, and have been touted by President Trump, despite little or no evidence of effectiveness.
This week, the FDA said it would enact new guidelines to toughen the process for approving a coronavirus vaccine. But President Trump said on Wednesday that the White House “may or may not” approve the plan, saying it “sounds like a political move.”
Saying they were “alarmed by political interference in science amid the pandemic,” the presidents of the prestigious National Academy of Sciences and National Academy of Medicine issued a statement on Thursday warning that “our nation is at a critical time in the course of the COVID-19 pandemic with important decisions ahead of us, especially concerning the efficacy and safety of vaccines.”
According to the Capitol Hill-based Roll Call, seven jurisdictions have indicated they would analyze the data independently: California, Colorado, the District of Columbia, Michigan, New York, Oregon and West Virginia. Another two — Montana and Wyoming — said they’d only administer a vaccine that completed clinical trials and an outside committee’s review.
“States are nervous. We’re talking about this now,” Marcus Plescia of the Association of State and Territorial Health Officials told Roll Call. “I think that a lot of public health officials in the states are concerned, given the rhetoric from the administration indicating they want a vaccine as quickly as possible.
But a state-by-state approach — for instance, if one state allows a vaccine, but another state does not — could complicate the pandemic response, which already varies greatly among states, said one expert.
While trust and confidence in the federal agencies has been shaken recently, “that is not the way to get control of this virus,” said Dr. Howard Koh, professor at the Harvard T.H. Chan School of Public Health, in a Sept. 16 media briefing. “Whenever a vaccine approval occurs, that needs to be accepted by the country, across the country, with implementation as a country.”
As to California’s numbers, Ghaly said Friday that the state is seeing upticks in case rates and hospitalization rates in some counties. They are small now but enough that the state is forecasting that 4,864 people will be hospitalized with COVID-19 by Oct. 25, an increase of roughly 89% from Wednesday, when there were 2,578 patients.
Dr. Mark Ghaly flagged “early signs” that state’s progress has shifted slightly: hospitalizations could rise from 2,578 patients now to 4,864 by late October
Dr. Mark Ghaly, Secretary of California’s Health and Human Services Department, addressed the state’s COVID-19 response in a Zoom broadcast Tuesday. (YouTube. July 21, 2020)
California could see an 89% increase in COVID-19 hospitalizations by the next month if coronavirus infections continue apace, a top state health official warned Friday.
Short-term forecasts indicate that hospitalizations could skyrocket from the 2,578 patients now hospitalized to 4,864 by this time in October, said California Health and Human Services Secretary Dr. Mark Ghaly during a Friday press briefing — a signal that Californians should stay vigilant as more parts of the economy open up.
“As we see these trend lines, which have been coming down and flattening, look like they’re coming up … we want to sound that bell for all of you,” Ghaly said. “We want to see us respond as a state to those slight increases.”
Although Ghaly praised the state’s “significant progress” in infection and hospitalization rates since mid-July — when a peak 7,170 COVID-19 patients were hospitalized — he flagged early signs that the state’s progress has begun to shift. Starting in mid-September, Ghaly said, infection rates have risen slightly across the state, while coronavirus-related emergency room visits have also climbed.
Although overall lower case rates have allowed many counties to reopen businesses within Gov. Gavin Newsom’s reopening system, the virus’ reproduction number has surpassed 1.0 in some regions, Ghaly said. Twenty-five of California’s 58 counties remain in the red or “widespread” tier, with another 19, including most of the Bay Area, in the purple or “substantial” tier, allowing for movie theaters and restaurants to welcome customers indoors at limited capacity.
Keeping case rates low means that the virus’ reproductive value has less of a dramatic effect on potential hospitalizations, Ghaly said — especially with the double whammy of flu season looming. But with more cases overall, “you can see how quickly case rates go up and how quickly that creates additional pressure on our hospitals,” he added.
Statewide, however, there was little change in the seven-day average of new infections and fatalities reported as of Friday. Both figures remained lower than where they were two weeks ago and significantly below their respective peaks. The 3,274 new cases and 85 deaths reported by county health departments Thursday kept each seven-day average about even — just over 3,500 cases and just below 84 deaths per day over the past week, according to data compiled by this news organization.
Ghaly’s hospitalization projection, meanwhile, would put the state on par with its Aug. 19 hospitalizations, when 4,890 people were hospitalized with COVID-19 — more than 2,000 people fewer than the state’s peak a month earlier.
“As Californians we’ve done a good job to avoid those situations, and we want to keep our guard up,” Ghaly said.
[For a complete archive of day by day data, see my Excel ARCHIVE – R.S.]
[Please note that some of the numbers of new deaths and hospitalizations this past week may not actually be new. The Fairfield Daily Reporter, quoting Dr. Matyas, is reported that some of the deaths reported Wednesday were updating discrepancies in reporting from last summer. Dr. Matyas confirmed in an email to me on Thursday that some of the spike in hospitalizations are also adjustments rather than new hospitalizations. No information as yet as to how many are new and how many are old. Regardless, these illnesses and deaths are still serious, sad and disturbing… – R.S.]
Friday, September 25: 31 new cases overnight, 5 hospitalizations, no deaths. Since the outbreak began: 6,309 cases, 389 hospitalized, 63 deaths.Compare previous report, Thursday, Sept 24:Summary
Solano County reported 31 new cases today, total of 6,309 cases since the outbreak started. Over the last 7 days, Solano reported 224 new cases, average of 32 per day.
Deaths – RECENT SPIKE: 3 new deaths reported yesterday, 3 the day before, and another 2 the day before that, total of 63 Solano deaths. Thankfully, no new deaths reported today.
Active cases – Solano reported 7 fewer ACTIVE cases today, total of 269. Note that only 21 of these 269 people are hospitalized, so there are a lot of infected folks out among us, hopefully quarantined. Is the County equipped to contact trace so many infected persons? Who knows? To my knowledge, Solano County has offered no reports on contact tracing.
Hospitalizations – the number of currentlyhospitalized persons remained at 21 today. However, the total number hospitalized since the outbreak started increased by 5 today, total of 389, an increase of 73 in just the last week.(see age group hospitalization stats below).
ICU Beds –The County reported 50% of ICU beds available, same as yesterday and down from 56% a week ago Monday. (After 7 weeks, still no information about availability of ventilators.)
Testing – The County reports today that 591 residents were tested today, new total of 86,789. Solano has a long way to go: only 19.4% of Solano County’s 447,643 residents (2019) have been tested.
Positive Test Rate
Solano County reported today that our 7-day average test rate remained steady today at 3.9%. Our supposedly smooth 7-day moving average has jumped all over the place recently (see note about delayed adjustments below). For the record, just two weeks ago we saw Solano rates above 7% for the first time since we peaked at 9.3% on July 22. Week before last we bottomed out at 2.7%. The County’s line graph for positive test rate looks like a flat line and tells us absolutely nothing, not worth posting here. Health officials and news reports focus on percent positive test rates as one of the best metrics for measuring the spread of the virus. The much more stable California’s relatively stable 7-day test rate remained at it’s lowest point, 2.8% for the 5th consecutive day today. (Note that Solano County displays past weeks and months in a 7-day test positivity line graph which also shows daily results. However, the chart does not display an accurate number of cases for the most recent days, as there is a lag time in receiving test results. The 7-day curve also lags behind current unknown results.)
By Age Group
Youth 17 and under – 5 new cases today, total of 701 cases, representing 11.1% of the 6,309 total cases. No new hospitalizations among this age group today, a total of 6 hospitalizations since the outbreak began. Thankfully, no deaths. In recent weeks it seems too many youth are ignoring public health orders. Cases among Solano youth rose steadily over the summer, from 5.6% of total cases on June 8 to 11% on August 31 and has remained around 11% since then. Youth are 22% of Solano’s general population, so this 11% may seem low. The significance is this: 1) youth numbers have increased steadily and at a faster rate than the other age groups, and 2) youth are SERIOUSLY NOT IMMUNE (!) – in fact 6 youth have now been hospitalized.
Persons 18-49 years of age – 20 new cases today, total of 3,783 cases. This age group is 41% of the population in Solano, but represents 60% of the total cases, by far the highest percentage of all age groups. The County reported 2 new hospitalizations in this age group today, total of 129 hospitalized since the outbreak began. No new deaths in this young age group today, total of 5 deaths. Some in this group are surely ignoring public health orders, and many are providing essential services among us. I expect his group is a major factor in the spread of the virus.
Persons 50-64 years of age – 3 new cases today, total of 1,197 cases. This age group represents 19% of the 6,309 total cases.
No new hospitalizations today, total of 104 hospitalized since the outbreak began. No new deaths in this age group today, a total of 13 deaths.
Persons 65 years or older – Today the County reported 3 new cases, total of 627, 3 new hospitalizations, total of 150. Thankfully, no new deaths, total of 45 of our elders who died of COVID. Much of the recent spike in this age group may be related to an outbreak at the Parkrose Gardens Alzheimer’s and Dementia care facility in Fairfield, where 31 patients and 8 staff were reported on September 15 to have tested positive. This age group’s 627 cases represent 9.9% of the 6,309 total cases. In this older age group, 23.9% of cases required hospitalization at one time. This group accounts for 45 of the 63 deaths, or 71%.
City Data
Benicia remained steady today, total of 165 cases since the outbreak began.
Dixon remained steady today, total of 413 cases.
Fairfield added 5 new cases today, total of 2,056 cases.
Rio Vista remained steady today, total of 48 cases.
Suisun City added 3 new cases today, total of 461 cases.
Vacaville added 4 new cases today, total of 1,056 cases.
Vallejoadded 19 new cases today, total of 2,090 cases.
Unincorporated areas remained steady today, total of 20 cases.
Race / Ethnicity
The County report on race / ethnicity includes case numbers, hospitalizations, deaths and Solano population statistics. This information is discouragingly similar to national reports that indicate significantly worse outcomes among black and brown Americans. Note that all of this data surely undercounts Latinx Americans, as there is a large group of “Multirace / Others” which likely is composed mostly of Latinex members of our communities.
Asian Americans are 14% of Solano’s population, and account for 9% of cases, 11% of hospitalizations, and 19% of deaths.
Black Americans are 14% of Solano’s population, and account for 11% of cases, but 18% of hospitalizations, and 24% of deaths.
Latinx Americans are 26% of Solano’s population, but account for 31% of cases, 30% of hospitalizations, and 21% of deaths.
White Americans are 39% of the population in Solano County, but only account for 21% of cases, 26% of hospitalizations and 25% of deaths.
Dr. Matyas – Thank you for your response to my email. With respect, I think I disagree. Regardless whether a daily update of TOTAL hospitalizations since the outbreak began includes ONLY new hospitalizations TODAY or both new TODAY and “newly learned in arrears” hospitalizations, the metric of total hospitalizations (and a 7 or 14 day average graph showing the curve of that metric) would be of great significance in understanding the overall spread of the most serious cases.
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