Good Morning:
Yesterday, Monday April 20 was a ONE Green Arrow Day.
The lone category that trending in the right direction was our newest, there were more recoveries based on our theoretical calculation which is total cases less deaths and those in extended care that are over two weeks old.
One could argue that this is a fair calculation because when a person is tested, in a likelihood, it wasn’t the first day they were infected with the virus. The symptoms might not manifest themselves for several days after the start of the infection.
Yesterday we are showing that there are 313,798 recoveries or about 44% of all cases. We view that when more than 50% are recovered as a key metric in overcoming COVID 19.
Why are recoveries so difficult to track and record? Part of that reason is the definition of recovery. According to the CDC, one standard is two negative tests at least 24 hours apart, the other standard is self-determined. Twenty-four hours of not having a fever without using fever reducing agents.
The vast majority of recoveries recorded in the US and around the world fall into the later category. There is quite a logistical challenge in making over 300,000 phone calls by healthcare workers to follow up and count those that are self-determined to no longer have COVID 19.
As we have discussed in previous posts our healthcare system does a pretty good job of recording a doctor or hospital visit for many reasons. When we go to the doctor with a cold or some other malady, the doctor might offer treatment with the instructions that if you don’t feel better in a few days or weeks, please let us know. The assumption is that if the patient doesn’t call back, all is well, and that there isn’t a note or code put into the chart to acknowledge that there was a recovery in these types of situations.
Without a formal process and follow-up system, those self-determined recoveries aren’t recorded. We’ve talked to both doctors and patients about this. Doctor’s believe some government representative are calling to follow-up. We know there are some phone calls to follow-up, but the evidence is sketch as to the percentage and how those calls if they happen are recorded. The point is we really don’t have a system to track and record all of the recoveries. Imagine the challenge to make 313,000 calls with detailed questions as to whether the patient has any of the multiple symptoms.
In summary recoveries are significantly underreported.
Perhaps the best way is random sampling or as one hospital system is doing, Beaumont Health (Michigan) is going to test 40,000 of its employees, affiliated doctors, etc. to test for the anti-body for COVID 19.
Enjoy your day.