The medical professionals on the White House Coronavirus Task Force appear to have lessened their reliance on academic models in favor of actual coronavirus data provided by state governments.
This move comes as the academic models that have brought about restrictive social distancing policies at the state and federal level continue to revise death projections downwards and vastly overstate hospitalization projections.
The Institute for Health Metrics and Evaluation (IHME) model that until recently was projecting 93,765 deaths has downgraded death projections to 60,415 as actual data has come in from several states. Meanwhile, the model’s hospitalizations projections continue to miss the mark by a wide margin and have yet to be corrected.
Dr. Deborah Birx of the White House Coronavirus Task Force said on Thursday that actual data on coronavirus testing and cases provided to the federal government by state governments around the country, rather than models, has become the driving force now in “understanding how to move forward together to really have a different future.”
“The original outbreaks were very large, but the newer ones that we talk about in Washington and Philadelphia and Baltimore it looks like their attack rates–and attack rates in Denver and some of these other states that we have been talking about–are much lower than New York and New Jersey,” Dr. Birx said at Thursday’s daily briefing at the White House.
“This gives us hope about really understanding how to integrate this information together, not dealing with a model, but the real live cases that are occurring, and understanding how to move forward together to really have a different future,” she added.
Birx elaborated on the value of the real data the medical professionals on the White House Coronavirus Task Force have analyzed as its been coming in:
We certainly know how desperate and difficult the situation has been in New York over the last few weeks. And we’ve been telling and talking about how this would be the week that would be most difficult because of the large proportion of cases that are coming from the New York metro area.
What’s been encouraging to us, those early states, outside of Washington and California, which have extraordinarily low attack rates because of their level of mitigation, all of the new areas that are having new increasing cases, we talked about them yesterday, Washington (D.C.) and Baltimore and the Philadelphia metro area–that includes Camden, Wilmington, and the counties around Philadelphia, we’re seeing that the case numbers, what we’ll get to as far as attack rates we talked about one in seven in a thousand in New York that are being measured. These are coming in even in their progress up the curve in the one to two per thousand range, showing that when you start mitigation early it has a very different impact.
All of this data is coming together. The testing rates, the seropositivity, the age groups, who really needs hospitalization, ICU. The innovative pieces coming from… we heard a great report from Louisiana this morning on the phone call where they talked about a minimum now of 40 percent of people coming off of ventilators alive and leaving the hospital. this is very encouraging to us.
Birx also provided details on the results of the more than 1.5 million coronavirus test results that state governments have reported to the federal government:
I’m sure you’re following our numbers every day. About 118,000 to 120,000 per day are being tested, so we’re way over the 750,000 per week currently.
We have some statistics, now we remember we required this, thanks to Congress, to be reported. We have about 75 percent of that test data in now, about 1.5 million of those tests have been reported in.
We’ve tested over 200,000 young people up to age 25. They have about 11 percent positivity rate.
Over half a million people between 25 and 45. They have a 17 percent positive rate. Now remember, in order to get tested you have to have symptoms, so this gives you an idea of the number of people who have symptoms who are not infected with coronavirus.
Another nearly half a million people between 45 and 65, their positivity rate is 21 percent.
Another nearly 200,000 between 65 and 85, 22 percent positive.
A small group of about 30 plus thousand people over 85 and they have a 24 percent positivity rate.
So this gives you an idea of where testing [is] throughout all age categories.
I see a lot of men in the audience today, I just want to remind them about the importance of health care. Of the male-female ratio, 56 percent of the people who are tested are female, 16 percent positive. 44 percent male, 23 percent positive.
Birx addressed key information about the coronavirus pandemic coming in from states that are largely rural:
I had a series of great calls with about 17 states that are in our more rural areas, specifically around our indigenous people and tribal nations.
It was a very reassuring call.we are testing across the country. We do have about 63 percent of states [Note: Birx is probably citing 32 states out of 51 reporting entities–the 50 states plus the District of Columbia] that are less than 10 percent positive despite significant testing. And within the indigenous peoples and tribal nations, they are seeing the same thing we are seeing across the nation. Increase issues among those with comorbidities and those of elderly, but also issues in nursing homes.
Many of these states are still capable of doing full contact tracing, and so they’ve been doing contact tracing from nursing home outbreaks and other outbreaks. It really gives us a clear impression, no matter what we do in the future, we need to really insure that nursing homes have sentinel surveillance . . . that we’re actively testing in nursing homes, both the residents and the workers, at all times.
Dr. Birx’s comments on Thursday came one day after she said at Wednesday White House Coronavirus Task Force briefing that the death projections from the academic models of coronavirus have been declining due to the mitigation behavior of the American people:
I know many of you are watching the Act Now model and the IHME model from — and they have consistently decreased the number, the mortality from over almost 90,000 or 86,000, down to 81,000 and now down to 61,000. That is modeled on what America is doing. That’s what’s happening.
And I think what has been so remarkable, I think to those of us who have been in the science fields for so long, is how important behavioral change is and how amazing Americans are in adapting to and following through on these behavioral changes. And that’s what’s changing the rate of new cases, and that’s what will change the mortality going forward, because now we’re into the time period of full mitigation that should be reflected within the coming weeks of decreasing mortality. I mean, that’s what we really hope to see.
We are impressed by the American people. And I think models are models. I’ve always worked on validating. I’ve spent my life validating models all over the world, and that’s why we do surveys and surveillance and we make sure that what we think is right is right.
Birx also noted on Wednesday that the White House Coronavirus Task Force has been carefully tracking real data on coronavirus cases and testing at the county level and metro locality level:
Yes, the number of cases has stabilizing — or is stabilizing, but I do want to go through those numbers with you because we talk about these as micro-epidemics in metro areas and in rural areas.
So, in the New York metro area — which includes, obviously, Northern New Jersey, Connecticut, and Rhode Island — there are still 11,000 new cases per day and their positivity rate on their testing is still in the 40 percent-plus range. So there’s still a significant amount of disease there and everyone needs to continue to follow the guidelines.
New Orleans metro area — 800 new cases per day, but a seropositivity rate on their testing of 28 percent. Detroit metro area — 1,400 cases per day, 26 percent positivity. Chicago — 1,200 cases per day and 18 percent. Boston — 18 percent positivity, 1,100 cases per day. Denver has fallen to 180 cases per day, but still has 15 percent seropositivity in their testing. California and Washington have stayed stable at about — Seattle, 350 cases per day. On the LA metro area — 800 cases per day, but their test-positive rates are remaining in the 9 percent range.
And so this really gives us some idea of what it takes. They have been continuously mitigating. Imagine what we’re talking about — New York going from 40-plus percent seropositivity and 11,000 cases a day, down to the LA metro area of 800 cases per day and 9 percent.
In an appearance on ABC’s Good Morning America on Wednesday, Dr. Birx told host George Stephanapoulos that the White House Coronavirus Task Force is drilling down on county level data:
So we track on a county by county as well as hot spot metro area. We also want to make sure we don’t miss any rural areas, so we were tracking for small outbreaks in rural areas, and the health commissioners and the local governments have handled those superbly, and we’re very confident that those were single outbreaks. And then we’re tracking the large metro areas. You know, we look at daily case reporting, but I think it’s really important that we look at those not only as single days, but combination of days and really look for trends. We also look at our testing data to see whether the number of test positives have started to decrease because we are doing a large amount of testing now, so we integrate all of that data.
We are concerned about the metro area of Washington and Baltimore, and we’re concerned right now about the Philadelphia area. All of our previous areas seem to be steady at least. And then certainly, we’re looking very carefully at California and Washington to really understand how they’ve been able as a community of Americans to mitigate so well.
The increased focus on actual coronavirus data by The White House Coronavirus Task Force is a likely indicator that a phased re-opening of the country will be based on state, county, and metro-specific data.