Sun. Nov 29th, 2020

As America continues Hedge in his efforts to control the COVID-19 pandemic, the data suggest that this piece-by-piece approach is backfiring – and the results are poised to be severe.

Here we are in November, and in countries around the world we are experiencing a second or third wave of epidemics in the winter months. We have learned a lot, but there is a lot that we have not understood.

As recent COVID-19 cases began climbing worldwide, deaths in many areas remained stable, causing confusion and concern that they would eventually begin climbing. As a news Report good Noted in September, “Nothing is strange in the two European countries that have been hit by COVID-19. The number of cases is increasing in the UK and Italy, but there is a steady and very small number of deaths, even That matters have begun to rise again. ”

Similar situation started coming up United States of america This summer, with many Thought One thing: Why are deaths increasing at such a rapid rate?

It is complicated to make sense of what is going on. Even America experiences back-to-back record number In daily COVID-19 cases, for example, counties and states may report respectively Decreasing Mortality rate record high Everyday death matters. Meanwhile, data animation Modeling It has been shown that during the early stages of the epidemic, case rates increased while mortality was often low. Yet there is an increase in mortality, pointing to the progression of the disease.

This puts a full premium on being able to rapidly detect the first indication that deaths have started to increase in specific geographic areas. Although deaths can be a lagging indicator, knowing that when they are about rapid growth can help prepare communities: hospitals can work to shore up beds and supplies, and leaders One can implement policies to stem the tide, ultimately preventing the spread of the virus. Fatal upbringing.

In MarchAt the beginning of the epidemic, our team made an introduction analytical approach To find out whether the variation in daily reports of COVID-19 indicates a meaningful change for better or worse. The approach has been an invaluable tool both locally and GloballyIn making sense of an increasingly complex data environment.

Status in United Kingdom Provides a good example of how the approach could have been used but was not. In late summer, after about five weeks of increasing COVID-19 cases, on 18 September our model detected the first sign of a significant increase in daily deaths in the UK, the first sign detected after more than 40 days, the British The leadership announced a four-week lockdown for England – a move that was too late, as deaths continue in the country Climb fast.

This type of chart (called the Shewert chart) shows the trajectory of the COVID-19 epidemic based on daily deaths over time. Notable changes occur when (1) a data point falls out of range, represented by dotted lines, and / or (2) eight consecutive points remain above the midline. On 18 September, the model detected several points that exceeded the upper limit. Britain is now in the development stage. (Note: Daily values ​​have been adjusted to address weekday signals Partiality In Reporting Death of COVID-19
Courtesy of Rocco Perla

The United States is now in similar territory and trouble, as our model demonstrates deaths Arizona, Minnesota, Nevada, New York And Texas – among other states – has begun to climb significantly again. Overall, on November 3, nationally, the first sign of meaningful growth in US COVID-19 occurred.

The optimistic news is that the signal came seven months ago, not a month and a half ago. There is still not enough time to stop what is happening in Britain now – but without taking action we would undoubtedly be in a similar, perhaps even worse, situation. Deferred action may mean more extreme action is needed later, as the situation becomes more severe.

To ensure this, authorities should not only decide on deaths, but other indicators such as cases and hospitalization. Deaths are an important indicator, he said, and the UK example shows how signs of increased death can be detected earlier when the government can act in the absence of this information.

This type of chart (called the Shewert chart) shows the trajectory of the COVID-19 epidemic based on daily deaths over time. Notable changes occur when (1) a data point falls out of range, represented by dotted lines, and / or (2) eight consecutive points remain above the midline. On 3 November, the model detected an eighth consecutive point above the midline, indicating that the US could enter a development phase. (Note: Daily values ​​are adjusted to address week-to-day signals Partiality In Reporting Death of COVID-19
Courtesy of Rocco Perla

Governments and institutions now face difficult decisions about opening and closing societies, which can be the difference between life and death. In the remainder of his days, members of the current US administration must work to keep things under control, as the new administration prepares to begin Management This crisis We don’t have 10 weeks Wait before taking action. State and local leaders must act with the same urge – if not more.

It is essential that this approach becomes part of regular reporting at the national and state levels to understand the trajectory of the virus and to direct our actions. Fortunately, the charts and analysis as we have presented here are publicly available to every country and every state in the US through the International Society for Quality in Healthcare’s COVID-19. Resource site. Charts identify the extent to which a state or country should consider implementing or relaxing lockdown strategies based on the number of deaths per day.

There is a lot of work to be done to keep COVID-19 under control, and we cannot do it without a way to understand if day-to-day changes in deaths simply reflect random variability or a true sign that the situation improves. Happening or deteriorating. . We will either take the wrong decision or act slowly.

We can’t start giving COVID-19 a heads up on our actions because we don’t Understand the difference Cannot separate the noise in our data and the signal.

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