November 23, 2020

On the topic of COVID, keeping people informed has been a challenge.  Since March, the situation has been incredibly fluid and has changed quickly, it has been very political, and many times any statement is met with resistance.  My email last week was strictly factual; as I stated in the first paragraph, I would leave my commentary to another time.   I wanted to inform subscribers of the increased restrictions imposed by the Governor.  The responses that the email generated ranged from, "thank you so much for keeping us informed," to I was "intentionally downplaying the virus and wanted people to get sick." The latter comment is ridiculous and couldn't be further from the truth.  I want to give subscribers my perspective and show them some of the information I have come across to help them make informed decisions for themselves.

To know where we are going, it is helpful to understand where we have been. Here is a brief summary:

On March 28th, the experts at predicted Maryland would have 52,750 Marylanders hospitalized at the peak of COVID infection rate.  This forecast assumed social distancing and frankly scared the hell out of everyone.  To put this in perspective at the time, Maryland only had about 4,000 hospital beds statewide.  Some elected leaders cast the prediction of an Italian situation, and images of people dying in the streets ran through people's minds.  This catastrophic prediction likely was the catalyst for the Governor issuing the shelter in place orders two days later and the term "flatten the curve" was being used widely. "Flatten the curve" meant that the infection period would be lengthened to ensure that we did not run out of medical resources. This set in motion a plan to quickly expand hospital room capacity around the state.  The state rented out hotels in Baltimore City and built temporary structures outside nearly every hospital in the state. If you drive through Leonardtown or La Plata, you will see the white temporary building outside the hospital doors.  The last time I checked in the spring, the current hospital capacity was more than 12,000 possible beds.      


The great news is most of those dire predictions never came true.  The Republican House Caucus was extremely successful at working with the Department of Health to add transparency to the situation.  The truth is, since the beginning of COVID, Maryland has not had more than 1,711 hospitalizations at any one-time, and since the beginning and as of this morning, the total number of Marylanders ever hospitalized is 19,769.  To my knowledge, none of the expanded temporary hospital rooms have housed a single patient.                                 

Below is a chart where you can compare spring to current hospitalizations:

A couple of interesting things to note about this chart. You'll notice that ICU care made up about 40% of the total hospitalizations in the spring, now it is closer to 20%.  This is excellent news as it's likely due to the advanced therapeutics being used to treat patients. 

Why are hospitalizations going up? There is likely a couple of different reasons for this.  It makes logical sense that as temperatures drop, people spend more time inside, where the virus is more easily transferrable.  It stands to reason the more cases, the more hospitalizations. Another reason the number of hospitalizations is slightly different as compared to the spring total is that HHS has updated its guidelines in October to include those in COVID observation beds for more than 8 hours as being hospitalized. 

The good news to remember regarding hospitalizations is that the people who are seeking treatment are being treated and, in most cases, are spending significantly less time in the hospital compared to the virus first impacted us in the spring.

Death rates:

Nothing disrupts life, liberty, and the pursuit of happiness like dying.  This gruesome fact has unfortunately become unbelievably political.  You have situations where people want to point to an area and say they did well or horrible with COVID simply if they are a blue state vs. red state.  Just this weekend, I was told by a lifelong friend that the deaths that occurred in Florida and Georgia happened because their Governors opened too soon and because they supported the president.  His opinion is more of a reflection of his news media sources than facts.  To get the best apples-to-apples comparison between states to see what states have performed better or worse, I suggest looking at John Hopkins states comparison chart.  Here is their break down of death/per hundred thousand cases to get an accurate measure:

Survival Rates of COVID:

With the censorship that has been going on by big tech, it has been hard to get out the updated survival rates.  I posted a graphic on Facebook that was produced by Florida Governor Ron DeSantis, and to my surprise, Facebook "fact-checkers" labeled it as fake news.

I find this to be an unbelievable violation of free speech because the information is readily available on the CDC website.

Some responses I have received doubt the updated statistics as they do the simple calculation of deaths/positive cases to come up with the mortality rate.  Calculating the death rate this way does not consider the updated medical treatments and the changes in public policy decisions.  An example of a public policy decision that changed is when some Democratic Governors stopped ordering COVID positive patients to be placed into nursing homes. 

A good to way translate those survival rate numbers:

0-19 years: 3 deaths per 100,000 infections
20-49 years: 2 deaths per 10,000 infections
50-69 years: 5 deaths per 1,000 infections
70+ years: 5.4 deaths per 100 infections

My position and summary

The bad news: Recent data shows COVID is more easily transmittable and likely is 2 or 3 times more deadly than the typical flu.  COVID is very dangerous for individuals with respect to their age, and preexisting conditions, specifically older adults, are much more vulnerable to the virus.

I wish public mask orders were an easy solution and a quick fix to return to normal.  The science on the effectiveness of masks is mixed at best.  Several recent studies suggest the cotton type surgical mask provides minimal protection.  Maryland has had a mask order since July, and  California and New York since May, yet cases have increased significantly. Over the last month, cases have significantly increased in all 50 states regardless of the mask or lockdown orders.

The good news: AstraZeneca today announced its vaccine with a 95% effective rate.  This is the third company in the last two weeks to announce that a vaccine should be widely available in the next few months, if not weeks.

My position: COVID is real, it is a pandemic, and it is certainly not the flu, but it is not the bubonic plague either.  What is concerning is the demonization of anyone that suggests anything other than locking yourself in your house as the only acceptable solution to this crisis.   

Over the past seven months, we have fought hard to get as much important and accurate information as possible, so when people make a decision that affects their health, they can decide for themselves.

I believe people should take reasonable precautions to protect themselves seriously, especially if you are in the high-risk category. For people who fall in this category, I believe it is your choice, but I would strongly encourage you to social distance away from people who are not in your household and to wear a medical-grade N95 mask with eye protection when you do need to leave your home.

For the rest of us, we need to deal with COVID the best we can and judge the risk tolerance of any activity for ourselves. I believe the last thing we need is wide-scale California style lockdowns.  The science does not support the claims of their effectiveness, and let's face it; every business is essential to someone.  Closing one business down while paying another to stay open is wrong, in my opinion. 

My personal view is that, given the information and the choice, people will do what they need to do to protect themselves and their families.  This isn't the first pandemic and certainly will not be the last. 

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