We’re now in week five of the coronavirus, and two of the big questions here in Rhode Island are how many people who’ve tested positive for the coronavirus have recovered and why isn’t anyone talking about it?
The answers to those questions aren’t simple or straightforward and the reasons many people are asking are just as complex.
First, we need to understand what the definition of “recovered” is.
During Governor Raimondo’s coronavirus update I posed the question to Dr. Alexander-Scott,
“What criteria must be met to diagnose recovery (for example, 2 neg tests) & can someone who’s recovered w/o testing carry & spread the virus?”
Dr. Alexander-Scott answered, “There are two strategies to be able to clear someone of COVID-19 or say that they have fully recovered. There is a test-based strategy which is two negative tests over more than a 24-hour period. We’re usually reserving that approach for folks who may be hospitalized with COVID-19 and the hospital needs to know whether or not personal protective equipment is still needed if a person has recovered from their symptoms but is still in the hospital.
The second strategy is a non-test-based strategy. It’s one just based on symptoms. This is what we are recommending for the majority of people who have COVID-19, hospitalized or otherwise. It means you have to have at least seven days since the symptoms began, you have to have the last three days be one that you have no fever, and that’s without taking any fever reducing medication. And the last three days have to involve improvement of symptoms and your symptoms need to have to have completely resolved. With all of those applied, that is when someone is considered recovered from COVID-19 and it’s particularly important for people who need to return to work.”
Dr. Alexander-Scott never got around to answering my second question, can someone who’s considered “recovered,” without being tested, still carry and spread the virus?
It is well known that the majority of people recover from COVID-19 without medical care, but that can take up to six weeks. Also, confirming recovery may not be the same as confirming whether or not someone is still carrying the virus.
A study published in The Lancet Medical Journal in March showed “that among the survivors, the median duration of which the virus could be detected was 20 days from the onset of their illness. The shortest observed duration of viral shedding among survivors was eight days and the longest was 37 days.”
I went on to ask, “How many in RI have recovered and is that number reflected in daily updates?”
Dr. Alexander Scott’s reply, “The way we are able to determine that is knowing the number of new cases that we have, plus being able to see who is hospitalized and then unfortunately know who has passed away. The remaining numbers between those two groups of numbers are all people who have recovered.”
Several Rhode Islanders were not too thrilled with her answer and I’ll get to that in a minute, but you have the formula as to how they calculate the number of recovered coronavirus patients. I did follow up on the second part of my question later during the follow-up press conference call, “I wanted to follow up on the number of recovered patients. Is that number reflected in the daily numbers and also is the number of recovered patients is that relevant in tracking and trending?”
Dr. Alexander-Scott replied, “It’s not reflected in the daily numbers that we’re giving. It is always certainly helpful to remember in terms of the number of cases that we have and knowing that given that total number of cases outside of those who are hospitalized currently and those who have unfortunately passed away all the rest of those cases have recovered. So that is always helpful to keep in mind in terms of how this is going forward.”
It’s about going forward and you have to remember that.
Many Rhode Islanders are not happy about the number of recovered patients not being included.
According to Douglas Donovan, a spokesman for John Hopkins University in Baltimore, "currently there is no uniform method for reporting recoveries across the United States.”
Why do so many want to know the number of recovered patients?
There are several reasons, and you can find people asking them all across social media. They range from people just wanting “good news,” to not wanting to “play into the media hype,” to even a way of “keeping the numbers inflated to instill fear and exercise more control.” The list goes on.
While many of these reasons do have some merit, none of them are really valid reasons as to why they’re not uniformly being tracked or updated.
Knowing the number of recovered cases aids in providing an accurate count of the total number of people that have been infected, and is useful in compiling better models of when the virus will peak. It’s also a way to gauge how easily people build an immunity.
That has been one of the biggest problems with modeling COVID-19 so far.
Effective and accurate models are created when they are based on known and reliable data. We can accurately predict what will happen during each flu season because we have decades of reliable data to base it on. When you try to create a model based on unknown data and variables, as we have been doing with COVID-19, you get an unreliable and inaccurate model which constantly needs adjustment.
The number of those who’ve recovered from COVID-19 will be helpful, just not in the way people want it to be at this time of uncertainty. If you crave that number for some good news, you now know how to calculate it and the majority of people who contract COVID-19 will recover without the need for medical care.
There has been a trend lately of people taking the number of positive cases, comparing that to the population of the state Rhode Island and proclaiming, “That’s not bad at all.”
That’s not the way it works. The only way that would work is if every person in the state was tested and then you compared those numbers. To make that comparison this early in the game is not only misleading but dangerous. You wouldn’t assume that if only 10,000 Rhode Islanders we’re tested for HIV and 300 tested positive, that 300 was pretty good out of the entire population of the state, would you? The same math applies here.
We’re getting there, but we’re not there yet.
Take life seriously but please don’t panic. Be smart and think of others before you act. When you think about it, shouldn’t we have been doing that even before the coronavirus landed on our shores?
Allan Giberti is the host of RI Red Radio on 990WBOB.com. You can listen to Allan live on Mondays and Tuesdays at 7pm Eastern.
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