What’s the New York data update of the week? – COVID-19 Questions and Answers

Question: What’s the New York data update of the week?

Answer: It’s been another week since we checked in on New York epidemic data (see Q&A of 4/10). If you’ve been following the news or watching Governor Cuomo’s daily press briefings, you’ll have a good idea of where things are. Still, it’s good to see some data and draw your own conclusions. So, here goes:

Daily Number Hospitalized (Table 1) has plateaued (~17,000 — ~19,000 per day since April 7th) and the Daily Number of ICU Patients (Table 1) has also plateaued (~5,000 — ~5,200 per day since April 11th). For both measures, there is even a slight dip in the last two days, but it’s still too early to call it the dip a decreasing trend. This continues to be good news! Of course, there are some caveats to this good news (discussed below).
Proportion of Hospitalized Patients in ICU (Table 2) is increasing from 23% to 28% over the last month. Additionally, the proportional increase has continued even as hospitalizations have plateaued. Now, the increase hasn’t been that dramatic, but these data (plus stories I’ve read in the NY Times) does make me wonder — is there a bias in terms of who is coming to the hospital now? Could some of the plateau in hospitalizations be the result of only sicker people getting hospitalized? This could be both because sicker people are trying to avoid going to the hospital and/or because EMTs are being more selective in who to take to the hospital. On the other hand, perhaps it only means that more people are staying alive and in the ICU longer, which is supported by Table 3. Maybe it’s a combination of the two? So many questions…
Daily Hospital Admissions (Table 3) seem to be decreasing. If we’re not just curbing, but are really blunting the epidemic, this is exactly what we would want to see. Now, it’s still too early to tell if this is a legit trend, but it’s promising nonetheless!
Number of New Cases remains high (Table 4). New York is still seeing a large number of positive cases everyday. Just yesterday, 8,505 cases were identified. representing 35% of everyone tested. Despite New York’s successes in conducting 20,000+ tests each day, it’s still far from adequate, as described in our Q&A of 4/10. Additionally, even though we know we need to be testing more people, the daily number of total tests completed remains relatively stagnant.
Daily Proportion of Positive Cases among All Tested may be decreasing (Table 5). As Table 5 shows, while the overall proportion of positive cases among all tested remains exceptionally high at 40%, it does seem that we may have started seeing slightly lower proportions of positive cases in recent days, which is modestly positive. I mean — yesterday’s proportion of 35% positive is nothing to write home about, but I suppose I’m feeling optimistic and hopeful that we’re seeing a declining trend. I might feel differently tomorrow. Yesterday, The Atlantic published a good discussion on this metric if you want to learn more.
Daily Deaths remain high (Table 6). With 630 deaths yesterday alone, the death toll in New York is staggering. It was >700/day for more than a week, so getting into the 600s is better… But damn, it’s terrible. And we know that it’s an undercount.
Crude Fatality Rate is increasing (Table 7). I guess I’m leaving this email with bummer news. In addition to the high numbers of deaths, the NYS case fatality rate is also increasing. Now there are lots of reasons this could be. Clearly, based on Table 5, we’re missing a lot of cases in our counts. So, this would inflate case fatality rates. But, we also know that we’re not capturing all COVID-related deaths, which would deflate case fatality rates. If we’re able to really expand testing to the degree necessary, we should start to see case fatality decline (our denominator gets bigger).