Your Community and COVID-19: How to Make Sense of the Numbers Where You Live
Have you felt a bit like an armchair epidemiologist lately? Maybe you've been poring over coronavirus statistics on your county health department's website or on the pages of your local newspaper.
If the percentage of positive tests steadily stays under 8 percent, that's generally a good sign.
You're likely to find numbers and charts but little guidance about how to interpret them, let alone use them to make day-to-day decisions about pandemic safety precautions.
Enter the gurus. We asked several experts to provide guidance for laypeople about how to navigate the numbers. Here's a look at several common COVID-19 statistics along with tips about how to understand them.
Case Counts: Consider the Context
The number of confirmed COVID-19 cases in American counties is widely available. Local and state health departments should provide them online, or you can easily look them up at The New York Times' coronavirus database. However, you need to be cautious about interpreting them.
"Case counts are the obvious numbers to look at. But they're probably the hardest thing to sort out," said Dr. Jeff Martin, an epidemiologist at the University of California at San Francisco.
That's because case counts by themselves aren't a good window into how the coronavirus is affecting your community since they rely on testing. And testing itself varies widely from day to day and community to community.
"The more testing that's done, the more infections you'll pick up," explained Dr. F. Perry Wilson, a physician at Yale University. The numbers can also be thrown off when tests are limited to certain groups of people.
"If the tests are being mostly given to people with a high probability of having been infected -- for example, they have had symptoms or work in a high-risk setting -- then we expect lots of the tests to be positive. But that doesn't tell us what proportion of the general public is likely to have been infected," said Eleanor Murray, an epidemiologist at Boston University.
These Stats Are More Meaningful
According to Dr. Wilson, it's more useful to keep two other statistics in mind: the number of COVID tests that are being performed in your community and the percentage that turn up positive, showing that people have the disease. (These numbers may or may not be available locally. Check the websites of your community's health department and local news media outlets.)
If the number of people being tested is going up, but the percentage of positive tests is going down, Dr. Wilson said, that's a good sign. But if both numbers are going up – the number of people tested and the percentage of positive results – then "that's a sign that there are more infections burning in the community."
It's especially worrisome if the percentage of positive cases is growing compared to previous days or weeks, he said. According to him, that's a warning of a "high-risk situation."
Dr. George Rutherford, an epidemiologist at University of California at San Francisco, offered this tip: If the percentage of positive tests steadily stays under 8 percent, that's generally a good sign.
There's one more caveat about case counts. It takes an average of a week for someone to be infected with COVID-19, develop symptoms, and get tested, Dr. Rutherford said. It can take an additional several days for those test results to be reported to the county health department. This means that case numbers don't represent infections happening right now, but instead are a picture of the state of the pandemic more than a week ago.
Hospitalizations: Focus on Current Statistics
You should be able to find numbers about how many people in your community are currently hospitalized – or have been hospitalized – with diagnoses of COVID-19. But experts say these numbers aren't especially revealing unless you're able to see the number of new hospitalizations over time and track whether they're rising or falling. This number often isn't publicly available, however.
If new hospitalizations are increasing, "you may want to react by being more careful yourself."
And there's an important caveat: "The problem with hospitalizations is that they do lag," UC San Francisco's Dr. Martin said, since it takes time for someone to become ill enough to need to be hospitalized. "They tell you how much virus was being transmitted in your community 2 or 2.5 weeks ago."
Also, he said, people should be cautious about comparing new hospitalization rates between communities unless they're adjusted to account for the number of more-vulnerable older people.
Still, if new hospitalizations are increasing, he said, "you may want to react by being more careful yourself."
Deaths: They're an Even More Delayed Headline
Cable news networks obsessively track the number of coronavirus deaths nationwide, and death counts for every county in the country are available online. Local health departments and media websites may provide charts tracking the growth in deaths over time in your community.
But while death rates offer insight into the disease's horrific toll, they're not useful as an instant snapshot of the pandemic in your community because severely ill patients are typically sick for weeks. Instead, think of them as a delayed headline.
"These numbers don't tell you what's happening today. They tell you how much virus was being transmitted 3-4 weeks ago," Dr. Martin said.
'Reproduction Value': It May Be Revealing
You're not likely to find an available "reproduction value" for your community, but it is available for your state and may be useful.
A reproduction value, also known as R0 or R-naught, "tells us how many people on average we expect will be infected from a single case if we don't take any measures to intervene and if no one has been infected before," said Boston University's Murray.
As The New York Times explained, "R0 is messier than it might look. It is built on hard science, forensic investigation, complex mathematical models — and often a good deal of guesswork. It can vary radically from place to place and day to day, pushed up or down by local conditions and human behavior."
It may be impossible to find the R0 for your community. However, a website created by data specialists is providing updated estimates of a related number -- effective reproduction number, or Rt – for each state. (The R0 refers to how infectious the disease is in general and if precautions aren't taken. The Rt measures its infectiousness at a specific time – the "t" in Rt.) The site is at rt.live.
"The main thing to look at is whether the number is bigger than 1, meaning the outbreak is currently growing in your area, or smaller than 1, meaning the outbreak is currently decreasing in your area," Murray said. "It's also important to remember that this number depends on the prevention measures your community is taking. If the Rt is estimated to be 0.9 in your area and you are currently under lockdown, then to keep it below 1 you may need to remain under lockdown. Relaxing the lockdown could mean that Rt increases above 1 again."
"Whether they're on the upswing or downswing, no state is safe enough to ignore the precautions about mask wearing and social distancing."
Keep in mind that you can still become infected even if an outbreak in your community appears to be slowing. Low risk doesn't mean no risk.
Putting It All Together: Why the Numbers Matter
So you've reviewed COVID-19 statistics in your community. Now what?
Dr. Wilson suggests using the data to remind yourself that the coronavirus pandemic "is still out there. You need to take it seriously and continue precautions," he said. "Whether they're on the upswing or downswing, no state is safe enough to ignore the precautions about mask wearing and social distancing. 'My state is doing well, no one I know is sick, is it time to have a dinner party?' No."
He also recommends that laypeople avoid tracking COVID-19 statistics every day. "Check in once a week or twice a month to see how things are going," he suggested. "Don't stress too much. Just let it remind you to put that mask on before you get out of your car [and are around others]."
Podcast: The Science of Recharging Your Energy with Sara Mednick
If you’re like me, you may have a case of email apnea, where you stop taking restful breaths when you open a work email. Or maybe you’re in the habit of shining blue light into your eyes long after sunset through your phone. Many of us are doing all kinds of things throughout the day that put us in a constant state of fight or flight arousal, with long-term impacts on health, productivity and happiness.
My guest for today’s episode is Sara Mednick, author of The Power of the Downstate, a book about the science of relaxation – why it’s so important, the best ways to go about getting more of it, and the time of day when our bodies are biologically suited to enjoy it the most. As a cognitive neuroscientist at the University of California, Irvine, Mednick has a great scientific background on this topic. After getting her PhD at Harvard, she filled her sleep lab with 7 bedrooms, and this is where she is federally funded to study people sleeping around the clock, with her research published in top journals such as Nature Neuroscience. She received the Office Naval Research Young Investigator Award in 2015, and her previous book, Take a Nap! Change Your Life was based on her groundbreaking research on the benefits of napping.
In our conversation, we talk about how work and society make it tough to get stimulation like food and exercise in ways that support our circadian rhythms, and there just as many obstacles to getting sleep and restoration like our ancestors enjoyed for 99 percent of human history. Sara shares some fascinating ways to get around these challenges, as well as her insights about the importance of exposure to daylight and nature vs nurture when it comes to whether you’re a night owl or an early bird. And we talk about how things could change with work and lifestyles to make it easier to live in accordance with our biological rhythms.
Show notes
3:10 – The definition of “upstates” and “downstates”
5:50 – The power of 6 slow, deep breaths per minute to balance the nervous system
9:05 – Watching out for mouth breathing and email apnea
13:30 – Different ways of breathing for different goals
16:35 – Body rhythms – what is heart rate variability and why is it so important?
21:05 – Are you naturally a morning or night person? Nature vs nurture
27:10 – The perfect storm that gets in the way of following our circadian rhythms
29:15 – The evolution of our pre-bedtime downstates – why it's important to check in with your cave mates
30:10 – The culture shift needed for more people to follow their circadian rhythms and improve their health
35:10 – Employers and communities can build downstates into daily work and life
38:15 – Choosing how we react to the world
41:00 – Being smarter about peak performance
45:09 – The science of pacing yourself for long-term productivity
49:42 – The science of light exposure for circadian rhythms
52:20 – Where to learn more about Sara Mednick’s research and writing
Links:
Sara Mednick’s website https://www.saramednick.com/ and her Twitter
Mednick’s recent book - The Power of the Downstate
Mednick’s book on the benefits of napping - Take a Nap! Change Your Life
The blue light blocking glasses recommended in Mednick’s book https://www.amazon.com/dp/B019C3O2UE?psc=1&ref=ppx_yo2ov_dt_b_product_details
An app for measuring heart rate variability - Elite HRV app https://elitehrv.com/
Thorne take-home Melatonin test
Podcast: The Friday Five weekly roundup in health research
The Friday Five covers five stories in health research that you may have missed this week. There are plenty of controversies and troubling ethical issues in science – and we get into many of them in our online magazine – but this news roundup focuses on scientific creativity and progress to give you a therapeutic dose of inspiration headed into the weekend.
Covered in this week's Friday Five:
- Sex differences in cancer
- Promising research on a vaccine for Lyme disease
- Using a super material for brain-like devices
- Measuring your immunity to Covid
- Reducing dementia risk with leisure activities