maybe you could give your opinion on why NY is an outlier here with so many more deaths than these other States. Some have now the same number of cases that NY had with half or quarter of the deaths. It wasn’t just NYC. Buffalo and Rochester had a lot of deaths back in March through May. Cases here in Western NY showed many hospitalized back then. Cases continue but hospitalizations are almost non existent here. So I’m having a hard time wrapping around the fact that we are better at treating it There just isn’t near the hospitalizations that there were. Treatment may be better but overall people aren’t being hospitalized any where near the level back in March. How can one say better treatment is causing lower deaths when the fact is people are less and less treated now than ever before My non professional opinion. Something has changed with the virus itself.
Right you are!! And it wasn't just NY, it was worldwide. Genomic sequence tracing has indicated a vast upswing in the number of infections from a viral mutant in the stalk region of the protein that allows it to enter your cells, which could impact its severity. So, that's one hypothesis. The other is that there were just so many undiagnosed cases in the early going because of lack of testing that the actual mortality rate was much less than has been reported. That hypothesis is being tested by looking at host antibody production in the general population. I also think that it's likely that older Americans are being much wiser now, too, since they're the most at risk.
Personally, I have concerns regarding the sensitivity of the "recommended" PCR test. This is based on my expertise, as it's something I do every day. Bear with me here. A positive readout has been set at a Ct, or theshhold cycle, of 40. Each cycle is the number of amplifications that are run and will result in a doubling of the product (2 becomes 4 becomes 8 becomes 16, etc...). So, a lower Ct means that the target is more abundant, because it takes less cycles of amplification to detect. Conversely, a higher Ct means a less abundant target. In real terms, this means that a person could test positive, but have so little target as to be physiologically meaningless. Maybe this is why we have so many asymptomatic cases? Treating a Ct of 20 (watch out, that person is going viral) and a Ct of 40 (likely no live virus) exactly the same is IMHO ridiculous. We should be reporting actual Ct and normalizing for sample content, as well.
I suspect that the clarity of the message trumps potential inaccuracies, and it's better to report a false positive than a false negative from a public health standpoint. Or so I've heard given as a rationale. As anyone who follows this thread knows, I'm a firm believer in evidence based medicine - but I'm beginning to get exasperated at the escalating restrictions, even as the situation improves. We should take a page out of Taiwan's book. They acted preemptively and eased restrictions as they became unnecessary.
In the meantime, I've got bucks to go harass. We just finished submitting a huge clinical training grant, and I'm due some R&R.